![[ Visit WOCN Website ]](images/banner09.jpg)
INTRODUCTION
Leptospermum Honey Alginate dressing is reported to be a cost effective, non cytotoxic, alternative to enzymatic debridement for wounds with eschar particularly when residents are not surgical candidates.
CLINICAL PRESENTATION
This case describes an 89 year old male with multiple comorbidities including CAD, diabetes, chronic renal failure on dialysis. He received a bipolar hemiarthroplasty for a fractured right hip and was discharged to long term care (LTC). Upon admission to LTC, a community acquired, unstageable, sacral pressure ulcer with a 10cm X 9.5 cm black eschar was identified. The patient had loose and liquid BM one to two times each shift. The size of the ulcer extended to the rectum which did not leave enough periwound surface tissue to secure an adherent dressing. Dressing changes were performed daily and prn when soiled.
METHODOLOGY
Leptospermum Honey impregnated calcium alginate dressing (HICAD) was selected as a non-caustic, natural alternative to pharmaceutical enzymatic agents for debridement. The HICAD was applied daily and as needed for soiling and covered with a foam dressing. Within two weeks the black eschar transitioned to thick tenacious slough. Within eight weeks the wound was beefy red, with surrounding tissue healed enough to permitted adherence of a dressing. Dressing changes were decreased to 3 x a week.
RESULTS
Black eschar was rapidly debrided with the HICAD. The wound remained infection free and the size decreased to 4.5cm X 4.7cm despite multiple comorbid factors. The patient was lost to follow-up due to a medical emergency.
CONCLUSION
Active Leptospermum HICADs enhanced wound healing in this resident with multiple co-morbidities. The dressing provided a pain-free, cost-effective alternative to an enzymatic debriding agent, and it was easy for staff to apply. Granulation tissue was enhanced, and no overgrowth of microorganisms was noted.
Leptospermum Honey Alginate dressing is reported to be a cost effective, non cytotoxic, alternative to enzymatic debridement for wounds with eschar particularly when residents are not surgical candidates.
CLINICAL PRESENTATION
This case describes an 89 year old male with multiple comorbidities including CAD, diabetes, chronic renal failure on dialysis. He received a bipolar hemiarthroplasty for a fractured right hip and was discharged to long term care (LTC). Upon admission to LTC, a community acquired, unstageable, sacral pressure ulcer with a 10cm X 9.5 cm black eschar was identified. The patient had loose and liquid BM one to two times each shift. The size of the ulcer extended to the rectum which did not leave enough periwound surface tissue to secure an adherent dressing. Dressing changes were performed daily and prn when soiled.
METHODOLOGY
Leptospermum Honey impregnated calcium alginate dressing (HICAD) was selected as a non-caustic, natural alternative to pharmaceutical enzymatic agents for debridement. The HICAD was applied daily and as needed for soiling and covered with a foam dressing. Within two weeks the black eschar transitioned to thick tenacious slough. Within eight weeks the wound was beefy red, with surrounding tissue healed enough to permitted adherence of a dressing. Dressing changes were decreased to 3 x a week.
RESULTS
Black eschar was rapidly debrided with the HICAD. The wound remained infection free and the size decreased to 4.5cm X 4.7cm despite multiple comorbid factors. The patient was lost to follow-up due to a medical emergency.
CONCLUSION
Active Leptospermum HICADs enhanced wound healing in this resident with multiple co-morbidities. The dressing provided a pain-free, cost-effective alternative to an enzymatic debriding agent, and it was easy for staff to apply. Granulation tissue was enhanced, and no overgrowth of microorganisms was noted.