Abstract: Clinical Case Series: Management of Wounds with Various Etiologies Using a Hydrophilic Wound Dressing (45th Annual Conference (June 22-26, 2013 ))

Janet Mullen, BSN, BEd, RN, CWOCN, CFCN¹, Carol Mathews, BSN, RN, CWOCN², Cecilia Zamarripa, MSN, RN, CWON³, Eugenia Mangel, BSN, RN, CWOCN³ and Jessica Johnston, BSN, RN, WOCN¹, (1)University of Pittsburgh Medical Center Passavant Hospital, Wound, Ostomy, Continence Nurse, Pittsburgh, PA, (2)University of Pittsburgh Medical Center Presbyterian Shadyside, Wound, Ostomy, Continence Nurse Clinician, Pittsburgh, PA, (3)University of Pittsburgh Medical Center Presbyterian Shadyside, Wound, Ostomy, Continence Nurse, Pittsburgh, PA

Clinical Problem:

The scope of practice for WOC nurses includes managing wounds caused by various etiologies, i.e. pressure, shear, friction and moisture. This series of clinical cases focuses on topical wound treatment, specifically the use of a zinc oxide-based hydrophilic wound dressing.

Past Management/Current Clinical Approach/Outcomes:

Case 1: 49-year old, morbidly obese male admitted to CVICU from ER. Placed on bi-level ventilator and bariatric rotational low air loss bed. Open area on gluteal cleft noted. Etiology: moisture/friction/pressure. Prior treatment unknown. Hydrophilic dressing applied. Day 12: Open gluteal cleft area had closed.

Case 2: 60-year old male admitted with wounds on left leg due to lymphedema. Staff nurse applied petrolatum dressing. Upon removal extensive periwound maceration noted. Within 48 hours after using a hydrophilic dressing, maceration had resolved.

Case 3: 68-year old male, two days post heart transplant with diabetic foot ulcer. Due to anticoagulant therapy sharp debridement was not an option. To promote autolytic debridement and soften the periwound callous a hydrophilic dressing covered with a hydrocolloid was applied. Day 22: Granulation tissue well established and periwound callous softened.

Case 4: 62-year old female, status post tumor debulking and hypothermic chemo perfusion for appendiceal carcinomatosis, admitted to SICU. Bordered silicone sacral dressing was applied pre-operatively. Upon removal a SDTI ulcer was noted on sacrum. Placed on rotational low air loss therapy and TPN started. Due to the wound location and etiology (pressure/shear) a hydrophilic dressing was applied. SDTI ulcer evolved into an unstagable ulcer. Day 10: Returned to OR. Post surgery, topical therapy remained the same. Day 29: Wound 100% debrided. Day 43: Complete wound closure.

Conclusion:

A zinc oxide-based hydrophilic wound dressing is a viable option for the management of wounds with multiple etiologies.

1413 Clinical Case Series: Management of Wounds with Various Etiologies Using a Hydrophilic Wound Dressing