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PROBLEM: Patient #1 had right ischial pressure ulcer with undermining. Patient #2 had Stage IV right ischial pressure ulcer with tunneling. Patient #3 had fasciotomy to forearm.
PAST MANAGEMENT: Patient #1 treated with half strength Dakin’s Solution. Patient #2 started on NPWT* at 175mmHg with minimal progress of wound healing in five weeks. Patient #3 had NPWT* complicated with foam adhered to granulation tissue.
CURRENT APPROACH: Patient #1 had undermining from 11:00 to 2:00 with maximum distance of 13.5cm. A collagen alginate** was placed into the undermined area. NPWT* started with foam overlay placed over the undermined area at 200mmHg.
After 5 weeks, undermining was discovered on Patient #2 extending from 11:00 to 4:00 with maximum distance of 7.5cm. Collagen alginate** was placed into the undermining and NPWT* started with foam overlay placed over the undermined area at 200mmHg.
Patient #3: Collagen alginate** placed in wound bed and wound edges pulled together with steri strips then NPWT* resumed with foam overlay at 150mmHg.
OUTCOMES: Patient #1 after 3 days had 10.8% decrease in area and 8.2% decrease in volume. After 10 days 24.1% decrease in area, 18.2% decrease in volume. After 25 days 37.7% decrease in area, 30.2% decrease in volume.
Patient #2 had 59.5% area and volume improvement after five weeks. After 2 days with the calcium alginate and foam overlay with NPWT* at 200mmHg showed decrease 74.5% area and 76.9% volume (a 15% and 17.4% decrease in 2 days). After 6 days, the patient had 77.5% area and 86.6% volume decrease (an 18% and 27.1% decrease in 6 days) of his wound.
Patient #3 had total area reduction of 66.5% and volume reduction of 90.4% in 24 days.
Conclusion: Collagen alginate** in undermined and tunneled tissue, in conjunction with NPWT*, facilitates accelerated wound closure.
DISCLOSURE: If accepted for presentation, expenses will be defrayed by KCI, Inc.
*Wound VAC InfoVAC with Silver Granufoam (KCI, Inc.)
**Fibracol Plus (Johnson & Johnson)
PAST MANAGEMENT: Patient #1 treated with half strength Dakin’s Solution. Patient #2 started on NPWT* at 175mmHg with minimal progress of wound healing in five weeks. Patient #3 had NPWT* complicated with foam adhered to granulation tissue.
CURRENT APPROACH: Patient #1 had undermining from 11:00 to 2:00 with maximum distance of 13.5cm. A collagen alginate** was placed into the undermined area. NPWT* started with foam overlay placed over the undermined area at 200mmHg.
After 5 weeks, undermining was discovered on Patient #2 extending from 11:00 to 4:00 with maximum distance of 7.5cm. Collagen alginate** was placed into the undermining and NPWT* started with foam overlay placed over the undermined area at 200mmHg.
Patient #3: Collagen alginate** placed in wound bed and wound edges pulled together with steri strips then NPWT* resumed with foam overlay at 150mmHg.
OUTCOMES: Patient #1 after 3 days had 10.8% decrease in area and 8.2% decrease in volume. After 10 days 24.1% decrease in area, 18.2% decrease in volume. After 25 days 37.7% decrease in area, 30.2% decrease in volume.
Patient #2 had 59.5% area and volume improvement after five weeks. After 2 days with the calcium alginate and foam overlay with NPWT* at 200mmHg showed decrease 74.5% area and 76.9% volume (a 15% and 17.4% decrease in 2 days). After 6 days, the patient had 77.5% area and 86.6% volume decrease (an 18% and 27.1% decrease in 6 days) of his wound.
Patient #3 had total area reduction of 66.5% and volume reduction of 90.4% in 24 days.
Conclusion: Collagen alginate** in undermined and tunneled tissue, in conjunction with NPWT*, facilitates accelerated wound closure.
DISCLOSURE: If accepted for presentation, expenses will be defrayed by KCI, Inc.
*Wound VAC InfoVAC with Silver Granufoam (KCI, Inc.)
**Fibracol Plus (Johnson & Johnson)