2008 SAWC/WHS Attendee Registration

303
Case Study

Traumatic right leg ulcer and the use of polymeric membrane dressing (with and without silver)

June Stamps, RN, CWS

Clinical Problem: A 73-year-old man presents with a traumatic right leg ulcer caused by a fall. Patient has a history of hypertension and complains of right leg wound pain. The patient was seen at the surgery clinic for sharp debridement and a tissue biopsy. A wound care nurse was consulted for wound care and the patient was seen on August 1. Previous wound treatment included saline dressings with no improvement. .Current Clinical Approach: The new plan of treatment included to apply a silver polymeric membrane dressing when signs of infection was present. The non-silver polymeric membrane dressing was used when signs of infection was not present. The dressing was changed every week and wrapped with kerlix. Silver polymeric membrane dressings contain nanocrystalline silver particles that provide antimicrobial benefit to decrease bacterial count to the wound bed. Polymeric membrane dressings provided decrease inflammation, managment of wound drainage and maintain moist wound healing..Patient Outcome: The right leg ulcer healed completely in 8 weeks. Patient had decrease pain during dressing changes..Conclusion: Polymeric membrane dressings are a choice of dressing type to use until complete wound closure..Behavioral Objectives: .1) Discuss problematic issues related to a traumatic wound..2) Identify the use of polymeric membrane dressings to decrease infection and pain..3) Identify polymeric membrane dressing used to enhance wound healing until closure.

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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

Lansdown ABG. Silver 1: its antimicrobial properties and action. J Wound Care. 2002;11(4):125Ð130

Rolstad BS, Ovington LG, Harris A. Principles of Wound Management: Acute and Chronic Wounds. In: Bryant RA (ed). Nursing Management. St. Louis, MO: Mosby, 2000.


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