Wound-Product Selection and Innovations

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PROBLEM: Five patients with differing wounds suffered issues with exudates, maceration and pain. Patient A was admitted 5/07 with thoracic surgical wound. Exudates increased with activity, as did frequency of dressing changes and patient's complaints of pain. Patient B was admitted 11/07 after multiple surgeries following near complete traumatic amputation of right leg. Patient had dressing change-related pain, fragile newly epithelialized skin and edema-related exudates. Patient C was admitted 10/08 with left lower extremity ulcer complicated by generalized edema and cellulitis. Had significant exudates, fragile peri-wound skin and dressing change-related pain. Patient D was admitted 10/08 postsurgical repair of right ankle. The wound drained copious serosanguineous fluid. Peri-wound skin was compromised by maceration, erythema and ecchymosis. Patient E was admitted 11/08 with nonhealing surgical wounds to back. Wounds were highly exudative with macerated and fragile peri-wound skin. The patient had dressing change-related pain. PAST MANAGEMENT: Patient A was managed with a dry dressing. Patient B had multiple treatments, including negative pressure wound therapy and silver hydrofiber.* Patient C was managed with silver hydrofiber* and gauze overwhelmed by edema-related exudates volume. Patient D was managed with 2% Chlorhexidine Gluconate 70% Isopropyl Alcohol*** pad over incision line with a gauze secondary dressing. Patient E was managed with silver hydrofiber* often adhering to the wound. CURRENT APPROACH: All patients had SSETD** initiated as primary or secondary dressing. PATIENT OUTCOMES: All patients had improvements in peri-wound skin condition. Patient B requested the “soft gentle dressing” when discharged. Patient D's maceration resolved within twenty-four hours of SSETD** use. All patients reported decreases in pain. The nurses caring for patients A and C reported decreased use of pain medication and need for dressing changes. CONCLUSION: SSETD** is an excellent option for managing wound exudates while maintaining/improving peri-wound skin condition and managing pain.