The Management of Heavily Exudating Wounds with Super Absorbent Dressing: Case Study 3

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 3

Mrs M is a 67 year old lady who underwent a repair of incisional hernia in August of last year. Her past medical history includes Arthritis, Asthma and 3 previous caesarean sections. She has suffered with a large umbilical and incisional hernia for 2 years resulting in several inpatient stays for problems related to this.10 days post op Mrs M’s wound was oozing haemoserous fluid. The following day alternate sutures were removed resulting in dehiscence of the wound. The remaining sutures were removed. The wound cavity was filled with sorbsan and a mesorb dressing pad applied as a secondary dressing. This required changing twice a day but strike through did occur prior to all dressing changes. Following referral to the Wound Care team 3 days later the dressing regime was changed to sorbsan and Eclypse dressing pad as the secondary dressing. Dressing changes reduced immediately to alternate days with no strike through occurring between dressing changes. This resulted in Mrs M being discharged home in the care of the District Nurse 11 days later. The wound was completely healed 6 weeks later.