Medical provider prepping surgery equipment. Post-surgical wound case study.

Post-Surgical Wound Case Study

patient overview

Patient is a 69-year-old female referred to Mendota Health with a chronic wound of the abdomen due to several large hernia repairs. Wound was 118 CM at initial consult and had been present for over a year when referred to Mendota Health for advanced wound care intervention.

wound management

Negative Pressure Wound Therapy (NPWT), Calcium Alginate, Optifoam, Xeroform Petrolatum Dressing, Hydrofera Blue Rope Antibacterial Foam Dressing, Debridement, Skin Substitute

wound presence

1 Year

time to heal

5 Months

Images of healing progression of a chronic post-surgical wound.

initial presentation

  • BMI 36
  • Type 2 diabetes
  • Hyperthyroidism
  • Ileostomy, due to complications with Ulcerative Colitis
  • Abdominal hernia surgery infection repair

assessment & management

The wound had periods of healing and deterioration due to infection that was controlled through debridement, dressing changes, and topical medication. Debridement was performed on the wound to remove devitalized tissue and disrupt biofilm. During the process of debridement wound tunneling was observed and treated with Hydrofera Blue Rope Antibacterial Foam Dressing.

Xeroform Petrolatum Dressing 5″ x 9″ was applied three times a week. Calcium Alginate and Optifoam dressings were applied. An abdominal sonogram and X-ray were ordered to rule out fistula due to ulcerative colitis. After the wound bed was prepped and tunneling was addressed, the wound was treated with skin substitute for 9 weeks.

outcome

The wound healed 99.9% resulting in less pain, less exudate, increased granulation tissue, increased epithelial tissue, wound edge contraction, decrease in depth of wound bed, improvement of appearance of wound bed, and increased quality of life. The patient had been afraid to get out of bed because she said it felt like her intestines were going to fall out of the wound. After the wound healed she was able to comfortably travel to see family in another state.

Pressure Injury Case Study

68 year old male with comorbidities of daily smoker, pre-diabetes, gout, hypertension, and hyperlipidemia who developed a deep pressure injury wound on his left heel that had been present for 4 weeks and another wound on his right 5th toe.