The Management of Heavily Exudating Wounds with Super Absorbent Dressing: Case Study 2

Sue Johnson RN MA EFNP Suppl. Pres CNS Wound Care & Kathy Leak RN BA (Hons) EFNP
Suppl.Pres. Sister Wound Care Doncaster and Bassettlaw Hospitals NHS Trust

Introduction

The management of exudates is a commonly cited clinical problem. All community based nurses have had at one time or another a patient, with limited mobility, with large oedematous legs that leak all over the floor. With an increasingly aged population and improved technology and operative expertise we are encountering more patients with large exudating wounds. When contained within the wound space, exudate performs a valuable role in wound healing. Excessive wound exudate or other bodily fluids, such as urine or sweat, can cause skin maceration to occur around a wound, which may delay healing and lead to other complications. To ensure an optimal healing environment correct dressing selection and use is paramount to ensure a positive healing outcome. A new highly adsorbent pad (Eclypse) is now available. The Dressing comprises of a rapidly wicking polyester and viscose spun woven face combined with a high capacity sheet of absorbent crystals and mechanically bonded cellulose pad. The backing is a polyester fluid repellent film designed to prevent strike through. The aim of this study was to evaluate the use of the new super absorbent dressing in management of heavily exudating wounds including dehisced abdominal wounds, fungating wounds and heavily exuding Leg Ulcers.

Of the twelve cases presented the results are as follows:

Results

The dressing pad performed better than the previously used dressing pad, reducing dressing changes by 50%. There was a reduction in skin damage due to the unique method of securing the dressing and a reduction in pain at dressing change again due to the unique method of securing the dressing.

Conclusion

The super absorbent dressing pad enabled the management of high levels of exudate and patients quality of life was substantially improved. There was a reduction in the number of hospital bed days as the exudates were managed better and therefore the patients was
able to be discharged earlier. The patients quality of life was improved as the fear of accidental leakage from their wound was removed. Their was a reduction in skin stripping due to the unique securing method negating the need for tape to secure the dressing pad in place.

Case Study 2

Mrs H is a 76 year old lady who underwent a left mastectomy and axillary clearance in December of last year. On the 6th January 2004 the wound dehisced and the wound was dressed according to the Breast clinic protocols. On the 13th January 2004 Mrs H was referred to the Wound Care team. On presentation the wound was completely dehisced with maceration of the skin edges and surrounding skin with some skin stripping, from the adhesive tape used, due to the wound requiring dressing two – three times a day. There was copious amounts of exudates, the wound bed was sloughy with some necrosis of the skin edges. The wound was dressed with Aquacel AG and the Eclypse dressing pad as the secondary dressing. Within a week the skin maceration had resolved, the wound bed showed 100% granulation tissue and dressing changes had reduced to daily. No strike through occurring between dressing changes. As the dressings were now secured with a netalast vest the skin stripping had also resolved. At the present time Mrs H’s wound has not completely healed but is now being managed with Aquacel and Versiva requiring changing two – three times a week.