| 154 |
Case Study
|
Efficacy of chemical enzymes in wound debridement Justine Hein, BSN, Dr. Benjamin Scharfstein, Bristol Regional Medical Center, Bristol, TN Case study of two patients who experienced mva's with subsequent crush injury and failed flaps First patient 38-year-old man experienced an mva on 6/5/05. Suffered a crush inury to the right leg and a tib-fib fracture. Had debridement in OR with ORIF of right tibia. Had MRSA surgical wound infection. Transferred to BRMC on 6/21/05. Wound care consulted. At time of consultation patient being treated with whirlpool with chlorhexidine. Receiving vancomycin.Whirlpool stopped. Chemical enzyme implemented for topical care. Ace bandages applied to control edema. Patient sent for HBO eval. -diagnosis-failed flap. HBO initiated. Complete debridement of wound accomplished within 3 weeks..Second patient 24-year-old man experienced an mva on 9/2/05. Suffered open tibia fracture and complete degloving injury of left lower extremity to include gastrocnemius muscle. ORIF and debridement on 9/3/05. Discharged from hospital 9/9/05. Patient sent for HBO eval. HBO initiated. First seen in wound care center on 9/20/05. Wound with 100% demarcated eschar. The wound bed was crosshatched. Chemical debridement was initiated.Treatment is ongoing but at this time (3 weeks) 75% of the debridement has been accomplished Papain-Urea Debriding Ointment- product monograph. Healthpoint..Bryant R. Acute and Chronic Wounds: Nursing Management. Mosby Year Book, Inc., 2004: St. Louis, MO. |
|