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Purpose statement:
Combining the proven methods of NWPT (negative pressure wound therapy) with topical treatments optimize wound healing. The synergism of these modalities promotes wound healing to closure whether it be surgical closure or the use of a conventional dressing.
Learning objectives:
The wound care specialist will be able to identify the benefits of NPWT, gauze dressings and adjunctive treatments.
The wound care specialist will be able to individualize wound treatments based on the status of the wound.
The wound care specialist will be able to understand the importance of optimizing the co-morbidities as an integral process to wound healing.
METHODS: Three patients were admitted to an LTAC with four wounds. Etiologies included pressure ulceration, abscess and post-operative wound dehiscence. A review of the data as it relates to wound healing is addressed in a case-study format.
RESULTS AND DISCUSSION: Three patients with an age range of 65 – 78 were admitted with multiple medical problems. Prior to admission to the LTAC each patient underwent aggressive intra-operative wound debridement. Upon admission, each patient had a pre-albumin level ranging from 11 to 19. Patient 1 had an abdominal wound secondary to a post-operative wound dehiscence. A foam-based NWPT was placed while in the acute hospital; he was then transitioned to gauze dressing. He required no narcotic pre-medication for his dressings with gauze NPWT; due to a purulent exudate, mupiricin ointment was added and NWPT continued. Patient 2 had two decubiti. The right buttocks decubitus had minimal fibrin with excellent granulation tissue. Collagen flakes were placed on the wound bed in conjunction with the gauze-based NWPT utilizing an alternating pressure of 40/80. Her second wound had a significant fibrin. A papain/urea ointment was applied to the wound base and continuous pressure at 80mmHg was utilized, removing the necrotic tissue. Patient 3 had a wound in the mid-scapular region. Intra-operative debridement removed the abscess cavity; mupiricin was applied to the wound base in conjunction with NPWT.
CONCLUSION: Choosing resources to optimize wound healing specific to each wound will better meet the physiologic, anatomic as well as emotional needs for each patient.
Combining the proven methods of NWPT (negative pressure wound therapy) with topical treatments optimize wound healing. The synergism of these modalities promotes wound healing to closure whether it be surgical closure or the use of a conventional dressing.
Learning objectives:
The wound care specialist will be able to identify the benefits of NPWT, gauze dressings and adjunctive treatments.
The wound care specialist will be able to individualize wound treatments based on the status of the wound.
The wound care specialist will be able to understand the importance of optimizing the co-morbidities as an integral process to wound healing.
METHODS: Three patients were admitted to an LTAC with four wounds. Etiologies included pressure ulceration, abscess and post-operative wound dehiscence. A review of the data as it relates to wound healing is addressed in a case-study format.
RESULTS AND DISCUSSION: Three patients with an age range of 65 – 78 were admitted with multiple medical problems. Prior to admission to the LTAC each patient underwent aggressive intra-operative wound debridement. Upon admission, each patient had a pre-albumin level ranging from 11 to 19. Patient 1 had an abdominal wound secondary to a post-operative wound dehiscence. A foam-based NWPT was placed while in the acute hospital; he was then transitioned to gauze dressing. He required no narcotic pre-medication for his dressings with gauze NPWT; due to a purulent exudate, mupiricin ointment was added and NWPT continued. Patient 2 had two decubiti. The right buttocks decubitus had minimal fibrin with excellent granulation tissue. Collagen flakes were placed on the wound bed in conjunction with the gauze-based NWPT utilizing an alternating pressure of 40/80. Her second wound had a significant fibrin. A papain/urea ointment was applied to the wound base and continuous pressure at 80mmHg was utilized, removing the necrotic tissue. Patient 3 had a wound in the mid-scapular region. Intra-operative debridement removed the abscess cavity; mupiricin was applied to the wound base in conjunction with NPWT.
CONCLUSION: Choosing resources to optimize wound healing specific to each wound will better meet the physiologic, anatomic as well as emotional needs for each patient.