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Case Study
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Use of silver antimicrobial gel on nonhealing surgical wounds to closure Salome Agbim, ND, CNS, APRN, BC, Kimberly J. Miner, ND, CNS, CWCN, FAPWCA, Wound Care Associates, Englewood, CO Objectives: Determine efficacy of silver antimicrobial gel (SAG) as primary dressing as standard protocol on non-healing surgical wounds. Establish whether protocol reduces nursing visits in home health setting Patient 1: Patient 65-year-old woman with right buttock surgical wound 11/04. History of COPD, neuropathy, hypothyroidism. Daily visits by SN. Wound measured 0.7x0.7x1.0 1/7/05. Wound care ordered MWF SAG with gauze and ABD dressing. Patient discharged 3/1/05 healed. Patient 2: Patient 77-year-old woman with LLE surgical wound. History of diabetes, cellulitis, osteoporosis, anemia, HTN, CAD with CABGx3. Daily visits by SN. Wound 50.0x1.5xeschar 6/23/04. Wound infected. Daily care ordered: SAG, alginate with 4x4 gauze. Debrided 7/7/04. Wound 15.0x1.3x0.05 7/23/04. Wound debrided, visits reduced to QOD. Patient received biweekly debridements. HH visits reduced to MWF 8/13/04, then M/Th 8/20/04. Patient discharged 9/23/04 Patient 3: Patient 61-year-old man with surgical wound to abdomen. Surgery 2/5/04. History of Fragile X syndrome and mental retardation, large bowel obstruction. Daily visits by SN. Wound measured 8.0x2.5x0.5 3/26/04 post-debridement. Daily care ordered: SAG, alginate with 4x4, ABD gauze cover. Wound 7.5x2.8x0.5 4/2/04. Wound debrided, visits reduced to QOD. Visits reduced to MWF 4/23/04. Wound debrided as needed during remaining course of treatment. Patient discharged 6/25/04. Patient 4: Patient 49-year-old man with surgical wound to left ankle post-I&Dx3. History of chronic foot pain, sarcoid deformities. Daily visits by SN. Wound 1.0x0.2x0.2 12/15/04. MWF care ordered: close with surgical tape strips, SAG with 4x4 cover. Patient discharged 1/5/05. Conclusion: Use of SAG, with sharp debridements performed as needed, facilitated closure of non-healing surgical wounds without complication or infection and contributed to reduced nursing visits by HH.. |
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