Wound case

[MM2007]

Hi,

You have the chance of using any type of dressing available, everything is at you dispsal.

Patient is female 62yrs old with a medical history of cancer of the breast, which has led to a left midclavicular fungating lesion in location, gradually advancing towards the left axilla. The lesion is heavy in exudate and malodour, the patient is palliative and good nutritional intake.

How would you propose to treat this wound.

Thankyou.

[leslie :-D]

-irrigate w/nacl

-wash w/ flagyl solution/gel

-carbon, charcoal or alginate packing

-protective coverings

bid-tid changes.

pt may need po flagyl if infection is systemic

flagyl is abt of choice against aerobic/anaerobic bacteria.

but with fungating lesions, wound consult is indicated as all lesions present uniquely.

different dsgs for different presentations.

leslie

[broadstreet]

-irrigate w/nacl

-wash w/ flagyl solution/gel

-carbon, charcoal or alginate packing

-protective coverings

bid-tid changes.

pt may need po flagyl if infection is systemic

flagyl is abt of choice against aerobic/anaerobic bacteria.

but with fungating lesions, wound consult is indicated as all lesions present uniquely.

different dsgs for different presentations.

leslie

good ideas.

the odor would prompt me to use an antimicrobial dressing that is absorbant as well. i've had good results with aquacell AQ. (mods - i'm not pimping aquacell, but you can delete if in violation of policy). any absorbent dressing w/ silver would be a good choice to manage the drainage.

i'd also keep an eye on the wound to watch for maceration of the edges if exudate is overly abundant.

i agree with a wound consult if your facility has a "wound team." if not, P.T.'s are all trained in advanced wound care, so you could get a P.T. consult for wound care. only a handful of P.T.'s actually practice wound care regularly, though. but most inpatient P.T.'s are pretty competent in wound care.

i used to work in P.T. and was part of the wound team many moons ago. i could probably use a refresher course or two by now.

just my two cents.