2005 Symposium on Advanced Wound Care | |
| 48 |
Case Study
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Managing a full thickness ankle ulcer in a 3-year-old child Alan J. Cantor, DPM, FACFAOM, CWS, Attending Surgeon, Burn/Wound & Hyperbaric Medicine Nassau University Medical Center, East Meadow, NY A 3 year old mentally retarded and developmentally delayed child was referred from Children’s Hospital with a 3.0 x 2.0 cm medial ankle ulceration caused by an infiltrated intravenous line. The initial visit revealed a necrotic ulceration on the medial aspect of the ankle with extensive tissue loss. Anatomically, the thin skin in this region predisposes the site to deeper infection of the joint and/or bone. Management included enzymatic debridement ointment* covered with a hydrodcolloid** dressing as the primary wound dressing. IV antibiotics were instituted. After one week the patient returned with improvement in the wound noted. Sharp debridement was implemented and same regimen continued. On week three, excellent wound improvement observed with significantly less necrotic tissue. The enzymatic debrider was discontinued and Hydrofiber® dressing with ionic silver*** and a hydrocolloid dressing were applied. This was continued for 3 weeks at which time the wound was fully epithelialized. Grafting which was anticipated was not needed. The child demonstrated no pain at dressing changes. No odor was noted and epithelialized tissue was noted to be quite responsive to use of the Hydrofiber® dressing with ionic silver protocol. * Accuzyme † DuoDERM® CGF® dressing ‡ AQUACEL® Ag Hydrofiber® dressing. DuoDERM CGF, AQUACEL and Hydrofiber are registered trademarks of E.R. Squibb and Sons, LLC. All other trademarks remain the respective property of their owners. |
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