(CS-045) The use of a charged antimicrobial barrier dressing to manage slough and necrotic tissue in unstageable pressure injuries in acute care settings.

Amirose Mallet, RN, BSN, CWOCN; Christine Pennington, RN, BSN, CWCN, CCRN, TCRN; Sarah Kogod, RN, BSN, CWCN

Introduction:

The presence of slough and necrotic tissue interferes with wound healing and allows the growth of microbes.  The removal of mechanical or other methods to remove such non-viable tissue can be supplemented now with charged dressings that have an inherent, design based construction to remove debris.  We evaluated a novel dressing* that supports debridement of slough in pressure injuries.

Methods:

We selected 3 patients with 4 unstageable pressure injuries (PI) in various locations in our acute care environment, and applied the dressing to the wounds that had 75-90% slough/eschar without underlying fluctuance.  The dressings were applied per the instructions for use, and changed when they were saturated, or when the wound required examination and covered with bordered foam during use.  We noted reduction in wound slough over time, until the wound no longer needed the use of this specialized dressing, or the patient was discharged. Case details are provided with photographic evidence.

Results:

Patient #1 had a PI on the mid back which had a 50% reduction slough in 1 week.  There were no dressing changes between evaluations.  Patient #2 had PI on the right lateral knee and right anterior tibia which were totally covered in slough/eschar.  There was 100% removal of slough/eschar in 12 days; the right lateral knee had 85% granulation tissue/15% fibrin and the right anterior tibial PI was 100% granulated.  These dressings were changed every four days and the slough reduction was achieved in 7 days.  Patient #3 had a coccygeal PI which was 80% slough/20% granulation.  There was 100% granulation in 7 days.  The dressings were changed every 3 days

Discussion:

Our initial evaluation of slough reduction in unstageable PI showed an average of 87.5% reduction of the visible slough in 7 days. The dressing was effective in removal of slough without pain or trauma to the wound/patient. On average, dressings were changed every 4 days. While the use of this dressing technology has been supported by randomized controlled studies, our case series provides clinical insights into how best to use the dressing on non-infected PI with slough to rapidly convert to healable wounds.