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Suzanne Koerner RN, CWOCN
Diane Adams RN, CWCN
Mount Carmel West
Columbus, OH
Problem: 3 patients with infected or bioburden-laden Lower Extremity exudating wounds, with pitting edema, and painful dressing changes.
Patient A: Admitted 7/13 with RLE MRSA abscess. 3+ pitting edema and surgical debridement. Copious serous drainage caused periwound maceration. Dressing changes very painful .
Patient B: Admitted 10/13 with RLE cellulitis, 3+ pitting edema and large ulceration distal to the knee that developed after blistering occurred following treatment with antibiotics. Purulent drainage caused periwound maceration.
Patient C: 90 year old with very fragile skin. Posterior leg wound with slough. Leg was edematous with serous drainage. Very painful when any dressing removed.
Past Treatment:
Patient A: Compression dressing* with Silver Hydrofiber*** .
Patient B: Non-adherent dressing and gauze, then compression dressing* with honey calcium alginate**** .
Patient C was placed in a Transparent** dressing and then a Soft Silicone dressing*****
Present Wound Care: All patients were treated with Soft Silicone-Exudate Transfer Ag Dressing over wounds with compression dressing for edema.
Patient Outcomes: All wounds showed decrease in size with granulation. Patients reported significant decrease in pain during dressing changes. Decreased number of dressing changes due to length of time the Soft Silicone-Exudate Transfer Ag Dressing remained under compression. Exudate was transferred through dressing which improved periwound skin and edema decreased. Patient A was compliant with follow-up care without the need for pain medication. Patient B was happy that her wound was healing quickly and continued with follow-up care. Patient C stated how grateful she was that her skin wasn’t “being ripped off” with each dressing change.
*Unna Flex, Kerlix, Coban
** Tegaderm – 3M
***Aquacel Ag – Convatec
**** Medihoney Calcium Alginate – DermaSciences
*****Mepilex Foam