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Case Study
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Combining ionic silver wound hydrogel and negative pressure for limb salvage Susan Girolami, BSN, RN, CWOCN The human body is in a constant fight against bacterial organisms. Conditions such as diabetes and hypoperfusion can impact the efficiency of immune responses. Bacteria can gain the upper hand if they can gain entry into the body, and overtake the ability of the body's immune system to fight. Bacteria is a known enemy of wound healing, placing wounds into a non-healing state and causing cellular senescence. A patient with a neuropathic heel ulcer presented in our clinic. This patient had a history of severe arterial insufficiency, IDDM, with a transmetatarsal amputation and complicating osteomyelitis. Initially, the patient presented with a blister in January of 2004 that evolved into a full thickness ulceration the following month. We had tried a myriad of different products including IV antibiotics and an artificial skin replacement in an attempt to heal the wound, with no success. On a final attempt at limb salvage, we started negative pressure therapy**. After two weeks, we added an ionic silver wound hydrogel* underneath the negative pressure therapy dressing. In less than 30 days, we noted that the wound had achieved an 80% reduction in size. We were pleased with the combination of the negative pressure and ionic silver wound gel. This wound was obviously old and senescent, as well as poorly perfused. The Ionic silver wound gel releases silver constantly to the wound, allowing several days between dressing changes. The products worked synergistically, keeping bacteria under control while maintaining an easy to apply dressing that was very effective in helping the patient to heal, while being cost effective. We will continue to utilize this combination of therapies for similar difficult cases The support of Medline Industries, Inc. is gratefully acknowledged *Silvasorbª Gel, Medline Industries, Inc..**Versatile 1 Wound Vacuum System¨, BlueSky Medical.. Crawford P. Guideline for management of wounds in patients with lower-extremity neuropathic disease. WOCN Clinical Practice guideline series. Glenview, IL: WOCN, 2004. Sieggreen M. Vascular Ulcers. In: Baranoski S, Ayello E, (eds). Wound Care Essentials: Practice Principles. Philadelphia, PA: 2004, Lippincott Williams and Wilkins Sussman C, Bates-Jensen B. Wound care: a collaborative practice manual for physical therapists and nurses. Philadelphia, PA: 2001, Aspen Publishers. |
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