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Case Study
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The utilization of a protease modulating matrix*** with silver along with vacuum-assisted closure* in a traumatic wound Connie Sarvis, RN, BN, MN, IIWCC, CON(c), CWS, Seven Oaks Hospital, Winnepeg, MB, Canada Wound healing is an interactive, dynamic 3-phased process, during which many variables may "stall" or prolong a phase. As healing is prolonged, the potential arises for complications such as wound infections and increased health care costs. Interventions that can "kickstart" or initiate the healing process are valuable tools for the health care team Mrs. P, a 59-year-old woman was admitted with an acute wound comprising approx. 80% of her buttocks of undisclosed origin. It was a clean, bleeding wound measuring approx. 30 cm x 20.6cm. x 7.4 cm. deep with numerous shreds of loose tissue After surgical debridement of some of the tissue shreds, we applied vacuum assisted closure*. Wound closure occurred at a rate of approx. 1.5 cm/week. At week 6, a tissue biopsy revealed that a Staphylococcus aureas wound infection was present. The patient was treated with Cloxacillin and a silver dressing* was placed under the vacuum sponge. At week 8, a follow up biopsy indicated the infection had resolved. Vacuum assisted closure* was used until week 12 for a average closure rate of 1.25 cm/week. From week 12-week 16, very little closure occurred At week 16, a repeat tissue biopsy was done to rule out a further wound infection. The biopsy was negative. At this time, a protease modulating matrix containing silver** was placed under the vacuum sponge and used with vacuum assisted closure*. The wound began closing at an average rate of 1.5 cm/week without complications until discharge at 25 weeks. *V.A.C., KCI USA, San Antonio, TX.**Silver dressingĂActicoat, Smith & Nephew, Largo, FL.***Protease Modulating Matrix with SilverĂPrisma, Johnson & Johnson, Somerville, NJ |
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