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Case Study
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Chronic nonhealing left medial ankle pressure wound and the use of polymeric membrane dressing Laura Barnes, RN, MSN, WOCN, CWCN, APN-CNS Clinical Problem: A 93-year-old man presents with a chronic non-healing left medial ankle stage 3 pressure wound x 1 year. Patient has a history of peripheral vascular disease, incontinence, immobility and dementia. Patient at risk for skin breakdown with a Braden Score of 10. Past wound management of triple antibiotic ointment and a variety of silver wound care products were found unsuccessful. A WOC nurse was consulted for wound care management..Current Clinical Approach: The new plan of treatment included to apply a polymeric membrane dressing every 1-3 days prn depending on the amount of exudate and to apply heel protector boots to alleviate pressure. The goal of therapy consisted of preventing infection, providing a moist wound healing and alleviating pressure. .Patient Outcome: After unsuccessful past wound management, the initiation of polymeric membrane dressings enabled the left medial ankle wound to heal to complete wound closure within 5 months..Conclusion: Polymeric membrane dressings cleans the wound bed by absorbing excessive drainage and therefore promotes the formation of granulation tissue by providing a moist wound environment. Polymeric membrane dressings are a dressing initially to consider for moist wound healing. .Behavioral Objectives:.1) Discuss problematic issues related to chronic left medial ankle pressure wound..2) Discuss polymeric membrane dressings for maintaining a moist wound environment to promote wound healing. Hess, CT. Wound Care Clinical Guide. Lippincott Williams & Wilkins. Ambler, PA: 2005 Rolstad BS, Ovington LG Harris A. Principles of Wound Managment Chapter 5 in Acute and Chronic Wounds Nursing Management. Ruth A. Bryant (ed). Mosby, St. Louis, MO: 2000. Rolstad BS, Ovington LG, Harris A. Wound Care Product Formulary Appendix 5.1 in Acute and Chronic Wounds Nursing Management. Ruth A. Bryant (ed). Mosby, St. Louis, MO: 2000 Yoong K, Sun L, Sung H, Lee H, Kim E. The Effects of Polymem on the Wound Healing. J Korean Soc Plast Reconstr Surg. 1999;109:1165Ð1172. |
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