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Case Study/Series
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Treatment of recal citrant ulcers with silver sulfate dressing First Author: SALOME AGBIM Authors: Salome Agbim, ND, CNS, APRN, BC Behavioral Objective: To evaluate the efficacy of silver sulfate dressing in the treatment of senescent wounds. To develop evidence based wound care protocols for implementation in all practice settings. Abstract: Silver sulfate dressings provide an effective, rapid, and sustained microbial load reduction against a wide range of microbes. The following cases illustrate the effectiveness of a new silver sulfate mesh dressing. A 79-year-old female with a 2-year chronic stasis ulcer to the right medial malleolus. PMH of chronic venous insufficiency, edema, obesity, and multiple failed grafts. Initial measurement was 1.5 x 1.8cm. Slough, copious exudate, inflammation and edema were noted. ABI was normal; osteomylitis and tissue pathology were ruled out. A series of treatment protocols were initiated including compression, debridement, nanocrystalline silver and biocellulose dressings, small intestinal submucosa wound matrix graft, and monochromatic infrared therapy. No progress was made. On 03/20/06 the ulcer measured 1.9 x 1.0 x 0.05 cm. Silver mesh dressing was initiated with 3x weekly changes. After 2 weeks ulcer now measured 1.0 x 0.3 x 0.025 cm. Exudate and periwound erythema decreased. The ulcer was closed on 04/24/06. A 90-year-old female presented with a chronic ulcer on the left index finger. PMH included dementia, hypothyroidism, and anemia. On 02/03/06 the wound measured 3.0 x 2.5. Treatments comprised skin protectant, cellulose dressings, absorbent and gel noncrystalline silver dressings, all without sustained improvement. On 05/19/06 ulcer was 1.2 x 3.0 x 0.015 cm. Silver mesh dressing was started with every other day dressing changes. Complete closure was achieved after one week. Conclusion: This easy-to-use silver mesh dressing led to rapid and permanent closure of difficult wounds not achieved with a variety of other treatments including alternative silver dressings. |
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