Trauma! Polymeric Membrane Dressings to the Rescue

PROBLEM

Patients with acute traumatic wounds desire quick healing, freedom from pain and infection and minimal inconvenience during wound care.  But, the more common scenario is exemplified by three dramatically different women: a healthy 18-year-old athlete whose deep shin abrasion became slough-filled during nine days of silver sulfadiazine, a 76-year-old with arthritis and venous insufficiency whose 3.7cmx3.2cmx1.7cm pretibial wound from hitting a metal corner became fibrin-filled during three weeks of antibiotic ointment, and a formerly healthy 58-year-old motor-vehicle-accident victim whose 1.5cmx2.7cmx0.2cm puncture and 5.5cmx8 cm abrasion remained unimproved after seven days of silver sulfadiazine.  All experienced slow healing and constant pain when using ointment under “non-adherent” gauze changed twice daily by a clinician.

RATIONALE

Polymeric membrane dressings’ built-in cleansing system helps prevent infection and simplifies dressing changes, because after initial cleaning/debriding, further manual cleansing is rarely needed.  Dressing changes are less frequent and can often be done by patients/families.  Polymeric membrane dressings donate moisture to dry wounds while absorbing excess wound exudate.  These dressings decrease wound pain by inhibiting nociceptor activity, and their truly non-adherent design usually makes dressing changes painless as well.

METHODOLOGY
After initial cleansing/debriding, polymeric membrane dressings were applied to the exposed surfaces of each wound; dressings were changed when saturated.  Only the 76-year-old required manual wound cleansing: twice after enzymes were attempted.  She also received compression.

RESULTS

The patients had no dressing-change-related pain.  Continuous wound-pain was eliminated within two weeks.  The 18-year-old performed two dressing changes without assistance, closing the wound in six days.  The 76-year-old had weekly dressing/compression changes; her wound closed in ten weeks.  The 58-year-old’s family dressed her wounds weekly, in-between weekly clinician visits.  Her wounds closed at three and four weeks. 

CONCLUSION

Polymeric membrane dressing treatment met these trauma patients’ goals: quick healing, freedom from pain and infection, and minimal inconvenience.