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Case Study
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Silver polymeric membrane dressing for management of chronic left lateral and medial malleolus wounds/venous insufficiency Judy Caras, CWOCN Clinical Problem: A 65-year-old woman with a history of venous insufficiency presents with wounds of the left lateral and medial malleolus. Patient's history includes chronic arthritis, hypertension, hypothyroidism, immobility and left malleolus wounds x 2 years. Patient was hospitalized with gastrointestinal bleed and severe anemia. Past wound culture showed MRSA in wounds with questionable pseudomonas. A WOC nurse was consulted for wound care. Past wound treatment included conservative debridement, daily wet to dry dressings or weekly compression therapy that were found unsuccessful.]..Current Clinical Approach: The new plan of treatment included silver polymeric membrane dressing along with weekly compression therapy. Polymeric membrane dressing selection was based on the condition of the wound and can be used up to 7 days. Silver polymeric membrane dressings have been tested and found to eliminate 99.9% of the following organisms: Staphylococcus aureus both MRSA and non-MRSA, Enterococcus faecalis (VRE), Klebsiella pneumoniae, Pseudomonas aeruginosa and Candida albicans Patient Outcome: The wound was healed within 6 weeks after initiation of management with silver polymeric membrane dressings.. .Conclusion: Silver polymeric membrane dressings eliminated bacteria to the wound bed and enhanced wound healing. This type of dressing can be used successfully with or without compression therapy. . .Behavioral Objectives:.1) Discuss problematic issues related to left malleolus wounds..2) Identify silver polymeric membrane dressing to eliminate bacteria and enhance wound healing. .3) Discuss polymeric membrane dressing with compression therapy for treatment of venous insufficiency. Cutting KF, White RJ. Criteria for identifying wound infectionÑrevisited. Ostomy Wound Manage. 2005;51(1):28Ð34 Ovington LG. Hanging wet to dry dressings out to dry. Home Healthcare Nurs. 2001;19(8):477Ð483..Ovington LG. The truth about silver. Ostomy Wound Manage. 2004;50(suppl 9A);S1ÐS10 Polymem Silver Antimicrobial Testing Summary MKLÐ177 Lansdown ABG. Silver I: its antimicrobial properties and action. J Wound Care. 2002;11(4):125Ð130. |
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