(CS-030) A Multifunctional Dressing for Effective Wound Care in Home Health

Four challenging wounds in Home Health (HH). Patient 1: 77 y.o. female; left heel Deep Tissue Pressure Injury (DTPI), present 38 days. Intermittent wound pain. Prior care: film dressing changed weekly. Patient 2: 64 y.o. male, bed-bound with left heel DTPI. Prior care: Daily Povidone Iodine, gauze for 14 days. Patient 3: with Sweet Syndrome, 41 y.o. male with right leg wound, present 28 days.  Prior care: Sharp debridement, Leptospermum honey 2-3x per week, plain foam 3x per week. Patient 4: 89 y.o. female taking Apixaban, fell.  Suffered a large forehead hematoma with periwound bruising with the fall, present 16 days. No prior care.

Methods:

Patient 1: Polymeric membrane dressing* (PMD) extra-thick applied 5 days after admission. Patient 2: standard PMD applied 14 days after initial assessment. Patient was already with HH. Patient 1 and 2, PMDs changed 1x week, as needed.  Patient 3: Standard PMD applied 88 days after admission. Dressings changed 1-2x week, as needed. Patient 4: sharp debrided, gauze absorbent daily dressing, PMD extra-thick applied 11 days after admission. PMD changed 2x week.  All wounds cleansed at dressing changes as per HH policy.

Results:

After PMDs initiated: Patient 1: Wound closed in 41 days, reduced pain. Patient 2: DTPI opened to stage 3. Which closed in 126 days; PMDs changed 3x/wk. decreasing to weekly. Patient 3: Wound closed in 111 days. Patient 4: Wound almost at closure at 56 days. After 2 dressing changes with PMDs, bruising resolved. Patient wanted a less noticeable dressing on the forehead; Bismuth Tribromorphenate applied under small adhesive dressing to closure for 14 days.  

Discussion:

Easy to use PMDs decreased complications; improved cooperation with dressing changes; decreased dressing change frequency and nursing visits. The ease of use of PMDs allowed for the caregiver to provide scheduled wound care with HH nurse supervision and meet the independence goals of patient/caregiver. PMDs are a multifunctional dressing for variety of wounds and improve wound healing to closure.