Infected post surgical wound treated with a silver impregnated wound cleanser and NPWT

Abstract of an Infected, Dehisced Abdominal Wound Treated with a Silver Impregnated Wound Cleanser and NPWT: A Case Study

A  morbidly obese patient was instructed to lose weight in order to control her Type II diabetes and hypertension.  Over the course of a year she lost 100 pounds and was left with a large pannus.  Surgery was performed on an out-patient basis and she was discharged home.  Three days later she was admitted with the surgical wound open and infected with pseudomonas, MRSA, and enterococcus faecalis.  The wound measured 85smX8.5cmx9cm with purulent drainage.  The Wound Care NP was consulted and advised that NPWT be utilized.  The wound was irrigated with a silver impregnated wound cleanser and applied a dressing.  The next day the tissue bed was red and the change over 24 hours was remarkable.  NPWT was initiated along with irrigation using the silver impregnated wound cleanser.  The patient was treated at the Out-Patient Clinic for dressing changes three times a week along with daily trips to the Infectious Disease Physician for IV antibiotics. When the wound was too small for NPWT it was discontinued and various dressings utilized to closure.  At the onset of treatment the patient was depressed and in pain.  As treatment progressed she became more optimistic and led a normal life within the constrict of her continuing wound care.  This case study is significant because of the size of the wound and the multiple organisms contributing to the infection.  Given its severity it responded well to treatment and closed in a relatively short amount of time.  Although NPWT is an extremely useful modality utilized in many challenging wounds it was felt that its use along with a silver impregnated wound cleanser contributed significantly to the uncomplicated course of treatment.