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Case Study
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Dramatic pain relief through the use of polymeric membrane dressings on a deep axillary wound Linda Benskin, BSN, Church of Christ Mission Clinic, Austin, TX A severely malnourished (15kg) six-year-old girl in Ghana, West Africa with axillary lymphatic tuberculosis for over 3 months came to clinic for malaria treatment. Wound from partial surgical excision at another facility two weeks prior was irregularly-shaped, 4cm x 4cm x 6cm deep, lightly exudating, malodorous, continuously painful and surrounded by inflammation and erythema. Had been dismissed with 3% H2O2 for cleansing and po antibiotics. Clinic transferred patient to hospital for surgical debridement, but patient dismissed after two days, having had no direct wound care. Family skepticism about ÒmodernÓ medical treatment for abscess plus patient's severe wound pain made immediate results critical. Clinic's other wound patients reported dramatic pain relief when treated with polymeric membrane dressings. Polymeric membrane dressings have demonstrated ability to reduce inflammation, as well. Silver polymeric membrane dressings and filler provide antimicrobial benefits. Therefore, polymeric membrane dressings were initiated. After sharp debridement at clinic, patient treatment focused on decreasing pain and infection through use of polymeric membrane dressings, filler and oral antibiotics, while improving patient's health through nutrition and prayer. Due to local conditions, TB treatment was delayed until wound was fully healed. Wound was managed with various polymeric membrane dressings from treatment initiation to complete closure, based on wound's condition. Initially, wound was lightly filled with silver polymeric membrane wound filler. Polymeric dressings conformed fully to wound's irregular shape and easily filled tunneling. Treatment with polymeric membrane dressings eliminated wound pain within 24 hours. Wound odor quickly diminished as well. Due to diagnostic error TB-infected lymph tissue was removed periodically. This was, of course, painful. Despite patient's severe malnutrition, recent malaria and active tuberculosis, wound completely closed in 16 weeks. Plain and silver polymeric membrane dressings and filler effectively addressed patient's wound pain, inflammation and infection from initiation of treatment to complete wound closure. Cutting KF, White RJ. Criteria for identifying wound infection: revisited. Ostomy Wound Manage. 2005;51(1):28Ð34 Hess CT. Wound care clinical guide. Ambler, PA: Lippincott Williams & Wilkins, 2005 Keen D, James J. A tool to aid nursesÕ decision making in relation to dressing selection. B J Nurs. 2004;13(15 suppl):S6 Ð S14 Lansdown ABG. Silver I: Its antimicrobial properties and action. J Wound Care. 2002;11(4):125Ð130 Ovington LG. The truth about silver. Ostomy Wound Manage. 200450(suppl 9A):1SÐ10S Rolstad BS, Ovington LG, Harris A. Wound care product formulary. In: RA Bryant (ed). Acute and Chronic Wounds Nursing Management, Second Edition. St. Louis, MO: Mosby, 2000 Coppi C. I dressed your wounds, God healed you: a wounded personÕs psychology according to Ambroise Pare. Ostomy Wound Manage. 2005;51(8):62Ð66 .. |
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