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Case Study
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Right thigh second degree burn and the use of polymeric membrane dressings Katherine Thurs, RN, MSN, NP-C, WCS Clinical Problem: On September 29, a 70-year-old wheelchair bound woman spilled scalding ham juice on her right thigh which resulted in a second-degree burn. Patient's history includes CREST Syndrome, non-healing ulcer to the left foot related to CREST Syndrome, right below knee amputaion related to peripheral arterial disease. Initial wound care by patient was to apply vasoline. No improvement was seen and wound was very painful and edematous. The patient was seen in the outpatient wound clinic by a nurse practioner. .Current Clinical Approach: The burn was debrided and the new plan of care consisted of polymeric membrane dressing changed three times per week wrapped with kerlix and secured with tape. The patient's protein intake was adequate but a multi vitamin and extra vitamin C supplement was added to the diet. The right thigh initial wound measured 5.7cm x 17cm with moderate amount of serous drainage. Patient complained of mild discomfort with wound care dressing changes. No further debridement was necessary after polymeric membrane dressing applied. .Patient Outcome: The right thigh wound healed in 14 days with initiation of polymeric membrane dressings on a patient with a challenging chronic underlying disease. .Conclusion: Polymeric membrane dressings are soft, flexible, absorbent and nonadherent. This dressing decreased inflammation, relieved wound pain, softened fibrin, decreased need for further debridement and prevented maceration. This dressing provided a more rapid healing rate. Polymeric membrane dressings are excellent dressings to use on second-degree burns..Behavioral Objectives:.1) Identify polymeric membrane dressings for use on second-degree burns..2) Discuss the benefits on choosing polymeric membrane dressings for wound care managment/second degree burns..3) Identify the advantages of using polymeric membrane dressings to decrease wound bed pain. Rodeheaver G. Controversies in topical wound management. Ostomy Wound Manage. 1988;20:58Ð68 Alvarez O. Moist environment for healing matching the dressing to the wound. Ostomy Wound Manage. 1988;21:64Ð83 Lee SK. A doctor's perspective on moist wound healing. The Remington Report. 2001;9(3):66Ð70 Murrey MT, Chuang AH, Rumner RR, Paustian PW, McPherson II JC, McPherson JC, Jr. Pluronic F-68 reduces post-burn edema. Presented at 3rd Annual Symposium on Advanced Wound Care, Richmond, Virginia, 1993. |
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