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Case Study
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Use of cellulose wound dressing to promote healing in chronic venous ulcer and reduce patient wound pain Mary K. Webb, RN, BSN, MA, CIC, San Mateo Medical Center, San Mateo, CA Problem: .How to provide optimal standard of care based on best practice to improve patient outcomes and promote healing by removing necrotic tissue, addressing infection. Social and emotional problems aid in wound care pain management with severe cardiovascular, respiratory, and renal disease. Solution: .Patient is admitted with pneumonia, hypoxia, renal failure, hyperkalemia, dislocated left hip, sepsis, full thickness, foul smelling, infected venous ulcer. Movement of either leg created severe pain. Wound treatment modality necessitated treatment to be tolerable for a compromised patient in severe pain with a non-adherent covering to the wound bed leaving no residue in the wound bed and requiring less frequent dressing changes. We will demonstrate with this case the progression towards healing by utilizing an advanced wound care product to aid in reduction of bioburden, reduce risk of re-infection, absorb exudate while hydrating wound and provide a pain-free dressing change for the patient Findings: .Comorbidities such as CHF, chronic kidney disease with renal failure, nutritional, social and emotional issues to name a few are things can significantly change the outcomes of a patient. We will present an older man with foul smell, necrotic, infected, full leg chronic venous ulcer. The history is suggestive for smoking and recreational substances as well as living surroundings not conducive to healthy living. While these ulcers are severely infected, the patient presented to the facility for treatment of fever, chills, difficulty breathing, chest pain, and inability to move opposite leg. Results: .We were able to maintain an infection free wound, reduce bioburden, reduce ulcer size, promote granulation tissue, improve nutritional status during acute illness and decrease patient's wound pain during dressing change and provide comfort between dressing changes. |
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