novel use of afm to manage at percutaneous devise sites
TRANSCRIPT
Novel Use of an Active Fluid Management® Dressing* to Manage Exudate at Percutaneous Device Sites
Objective
Materials and Methods
Patricia Keller, BSN, CWCN and Janice Ranger, BSN, CWOCNNorth Greenville Long Term Acute Care Hospital, Travelers Rest, SC
Patients with tracheostomies, percutaneous endoscopic gastrostomies and drainage tubes can develop complications ( maceration, excoriation, edema, redness) of the periwound area due to exudate/drainage build-up. The objective is to use a novel fluid pumping dressing* to move exudate/fluid away from the percutaneous device sites to an absorbent material.
The patient is a 58 year old female who was admitted for respiratory failure s/p sepsis requiring tracheostomy. Tracheostomy site was initially dressed with gauze. After a few days, the wound site had dry blood and scab with periwound edema and redness. One week after switching the dressing to an antimicrobial Active Fluid Management® dressing* with an absorbent secondary foam dressing, the wound was much improved. The problems were completely resolved after two weeks.
The patient is a 56 year old female who was admitted for community acquired pneumonia complicated with respiratory failure. The tracheostomy site was initially dressed with gauze and foam dressings. Redness developed around the tracheostomy site due to moderate amounts of exudate. After application of the antimicrobial Active Fluid Management® dressing* with a secondary absorbent foam, the periwound showed improvement within one week. After three weeks, the issue was completely resolved.
Three patients were admitted to the facility for ventilation weaning. One of the patients also had a percutaneous endoscopic gastrostomy (PEG). The percutaneous device sites were initially treated with gauze dressings and absorbent foams, depending on the amount of exudate. However, the periwound areas developed complications because the gauze and foam dressings failed to adequately manage the wound fluid. Subsequently, a novel Active Fluid Management® dressing* along with secondary dressings of various absorbency were used.
ResultsComplications around the percutaneous sites, caused by wound exudate, were successfully treated with an antimicrobial Active Fluid Management® dressing* along with absorbent secondary dressings. Improvements were seen in a matter of days, with issues being completely resolved within one to three weeks.
ConclusionsPercutaneous device sites are prone to complications related to excess wound fluid. Standard absorptive dressings often do not provide adequate wound fluid management to avoid site complications. Active Fluid Management® dressings* were successfully used to treat complications resulting from wound exudate at percutaneous device sites previously treated with absorbent foam or gauze.
The patient is a 58 year old female who had a myocardial infarction complicated with respiratory failure requiring tracheostomy. The patient also had a PEG.
Tracheostomy: After ten days of management with gauze, the tracheostomy site developed redness with a small amount of exudate. The treatment was subsequently changed to the Active Fluid Management® dressing*. After one week, the site showed some improvement. After two weeks, the redness around the tracheostomy site was completely resolved and the cannula was resolved.
PEG: Five weeks after being admitted to the LTAC with the PEG tube, the patient complained of pain and redness at the PEG site. Cultures were obtained and the results were negative. The dressing was changed from gauze to an Active Fluid Management® dressing*. After five days, the issue was resolved, the PEG tube was removed, and the patient was discharged.
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*TRITEC™ SilverMilliken Healthcare Products, [email protected] | healthcare.milliken.com | 1-866-491-6556 | 920 Milliken Road, Spartanburg, South Carolina, 29303 USA© 2013 Milliken Healthcare Products, LLC. All rights reserved. TRITEC™ and Active Fluid Management® are trademarks of Milliken Healthcare Products, LLC.
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CASE STUDY
Milliken Healthcare Products, LLC
Novel Use of an Active Fluid Management® Dressing* to Manage Exudate at Percutaneous Device Sites