Successful Healing of Digit Wounds with One Dressing

Clinical Problem

Whether a wound results from trauma or another type of injury, the healthy healing of wounds involves establishing and maintaining an optimal wound healing environment. 4 patients are presented with digit (hand or foot) wounds. Cases 1, 3, and 4 experienced traumatic injuries. Case 2 developed a friction wound. Case 1: A 78 y.o. diabetic male developed 3 blood filled blisters on the second toe of the left foot. Case 2: A 71 y.o. diabetic male developed a weeping wound on the left foot, 2^nd toe.  Case 3: A 56 y.o.  quadriplegic female avulsed the 2^nd toenail, left foot. Case 4: A 56 y.o. male had a painful 1^st digit wound, right hand.

 Past Management

No past management for Cases 1-3. Case 4 had surgical flap of traumatic amputation, pain medication, daily whirlpool and wet-to-dry dressings for 3 weeks.

Current Clinical Approach

A silver polymeric membrane finger/toe dressing was applied to the blisters of case 1. The standard polymeric membrane finger/toe dressing was applied to the wounds of cases 2-4. Case 4 continued with whirlpool. A barrier cream was applied on the periwound skin due to maceration from the whirlpools.

Patient Outcomes

Polymeric membrane dressings provided significant improved outcomes. The wounds healed rapidly. In less than 2 weeks, Case 1’s blisters healed.  Case 2 healed in 2 weeks. Case 3 healed in 3 days. Case 4’s pain decreased from 10 (0-10 scale) to 2 with polymeric membrane dressings and the dressings encouraged autolytic debridement. Analgesia was only needed during whirlpools. Only 6 polymeric membrane dressings were used, compared to prior daily dressing changes. The wound healed in 21 days.

Conclusions

Polymeric membrane dressings provided an optimal healing environment. Nurses, patients and family found the dressings easy and convenient to use.