2005 Symposium on Advanced Wound Care | |
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Case Study
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Rapid intervention in a critically burned patient with sepsis from infected pressure wounds on his feet Alan J. Cantor, DPM, FACFAOM, CWS, Attending Surgeon, Burn/Wound & Hyperbaric Medicine Nassau University Medical Centet, East Meadow, NY A 54 year old male arrived at the burn center after sustaining severe burns to his head and face in a car fire. Patient was unconscious and in critical condition for several weeks. Patient became septic with positive blood cultures for MRSA, VRE, and multiple other pathogens isolated from his blood. He was ventilated and his condition continued to deteriorate. The Burn team consulted author when both feet were noted to have developed pressure ulcerations after 6 weeks of immobility. Large, necrotic, infected ulcers were noted B/L with severe abscess on the right lateral foot. The patient was brought to OR for radical debridement of infected tissue and abscess drainage on both feet. Wounds were initially managed with negative pressure therapy for 2 weeks. Wounds were then packed with Hydrofiber® rope with ionic silver* and covered with foam for protection. Appropriate culture derived antibiotic therapy was continued. After the foot surgeries, labs began to normalize, the sepsis resolved and patient was alert, oriented and removed from ventilator. Within 8 weeks both feet were fully healed. It was the consensus of the entire team that recognition and rapid resolution of the infections in the foot allowed this patient to survive, as the sepsis was seeded from the foot infections. Patient made a full recovery of all of his injuries, including head, face and feet. * AQUACEL® Ag Hydrofiber®, E.R. Squibb and Sons, L.L.C. |
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