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Case Study
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Pyoderma gangrenosum and the use of polymeric membrane dressing Mariama Hubbard, MA, NP, APN, Jersey Shore University Medical Center, Neptune, NJ A 59-year-old woman was diagnosed with endometrial carcinoma and underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy and lymph node biopsy on March 11th. The patient was unable to work. She followed up with her primary care physician 2 weeks post surgery to remove staples from her abdominal incision. At that time she was noted to have a wound infection and was diagnosed with an abdominal cellulitis and started on oral antibiotics for 10 days. There was no improvement and the patient was hospitalized in April. A wound biopsy was performed with the results indicating pyoderma gangrenosum. The patient was started on oral steroid therapy. The past wound care management included a hydrofiber dressing that was found unsuccessful. She complained of increased pain with the wound care and dressing changes. The patient was placed on pain medication to decrease pain during dressing changes. No wound improvement was noted and the patient was referred to the wound center on May 2. A wound care nurse was consulted for wound care. .The new wound management included post wound debridement of necrotic tissue and polymeric membrane dressing was initiated. The wound care/dressing management included changing the polymeric membrane dressing three times per week. The abdominal wound measured 21cm x 34.5 cm with a depth 0.3 cm, large amount of serous drainage. Polymeric membrane dressings are soft, flexible, absorbent, nonadherent, and relieve wound pain..The patient outcome was the wound healed within 45 days of initiation of polymeric membrane dressings..Polymeric membrane dressings are excellent dressings to use on necrotizing, inflammatory skin diseases/wounds to manage exudate and relieves pain to wound bed and during dressing changes. Kim Y, Lee S, Hong S, Lee H, Kim E. The effects of polymem on the wound healing. J Korean Soc Plast Reconstr Surg. 1999;109:1165Ð1172 Ladin DA. Understanding dressings. Clin Plast Surg. 1998;25:433 Habif T, Campbell J, Chapman M, Dinulos J, Zug K. Skin Disease Diagnosis and Treatment. Philadelphia, PA: Elsevier Mosby, 2005. |
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