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Case Study
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Porcine xenagraft as an alternative treatment to STSG for acute trauma wound Kimberly J. Miner, ND, CNS, CWCN, FAPWCA, Wound Care Associates, Englewood, CO. Objectives: Illustrate successful use of porcine xenagraft as alternative to STSG..Identify type of wound that may use porcine xenagraft as alternative Case study:.Patient 69-year-old woman who traumatized anterior shin during PCP visit the week of 1/15/05. Wound was sutured at that time. Patient visited a surgeon on 1/29/05 who opened the wound and debrided site. Surgeon scheduled the patient for a plastic surgery consult to consider STSG. On 2/4/05 the wound measured 3.5x8.0x0.15. Wound bed was 10% slough with copious thin serous/serous sanguineous exudate. Skin periwound warm with edema and erythema. Patient performed daily dressing changes: papain-urea-chlorophyllin copper complex sodium ointment (PUC) placed in the wound bed and trypsin, balsam peru, and castor oil (TBC) placed periwound. Wound dressed with gauze. Plan was followed for 11 days to eliminate necrotic tissue On 2/15/05, the wound measured 3.4x6.9x0.1. Wound was debrided and porcine xenagraft was applied to the wound bed. Wound was then covered with a silver dressing, foam adhesive dressing and light compression wrap. Porcine xenagraft was applied again 2/18/05, with UNNA boot cover. Patient received three more applications subsequently and on 3/3/05 wound measured 1.2x4.0x0.05. Patient was sufficiently healed to discontinue porcine xenagraft and continued treatment with a combination of PUC, TBC and silver dressings to healing. Wound healed on 3/21/05. Patient reported pain at start of care and some discomfort from UNNA boots during course of treatment, but no pain from wound during or subsequent to porcine xenagraft applications. Patient completed all care between clinician visits Conclusion:.-Porcine xenagraft provided sufficient scaffolding to allow wound to heal without further surgical intervention. .-Interim care was easily accomplished by patient, eliminating need for more frequent physician or nursing visits. |
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