Managing Non-Healing Wounds Using Hydrophilic Wound Dressing

CLINICAL PROBLEM: Moving wounds through the process of healing requires the removal of necrotic tissue, promotion of healthy tissue within the wound bed, moisture balance, and protection of periwound skin.  Management of chronic wounds becomes a challenge when patients show no progress in their healing despite use of multiple wound care strategies, patient support, and education.  Three case studies will be presented: 68 year old male with a left lower leg venous stasis ulcer, 21 year old male with Stage III and Stage IV pressure ulcers, and a 72 year old female with a right lower extremity traumatic wound. The patients have various co-morbidities that affect their ability to heal, and one patient has personal circumstances affecting his ability to maintain care.  Each of these wounds have been present for more than 6months leaving the patient frustrated with the lack of progress toward closure. Transition of wound management using Hydrophilic Wound Dressing (Zinc Oxide, Dimethicone, Petrolatum, and Carboxymethyl Cellulose (CMC) was implemented.

PAST MANAGEMENT: Management strategies were patient specific.  These included negative pressure wound therapy, enzymatic debridement, hydrogel dressings, hydrofiber silver dressings, compression therapy, and topical anti-microbial medications.

CURRENT CLINICAL APPROACH:  Hydrophilic Wound Dressing was utilized as impregnated gauze dressings to fill a deep wound or direct application to cover a shallow wound, applied peri-wound as skin barrier protection, and then covered with dry dressings. Dressings were changed once daily.

PATIENT OUTCOMES:  Hydrophilic Wound Dressing demonstrated effective removal of necrotic tissue, promotion of granular tissue, and protection of peri wound skin. All patient wounds showed improvement as evidenced by debridement, reduction in size, and reported satisfaction with the process of wound care. 

CONCLUSION: Hydrophilic Wound Dressing is an effective wound care strategy for non-healing wounds.  Indications for use in the management of acute wounds should also be considered.