Failure of Healing in Chronic Diabetic Wounds: A Case Report
| Autor: | James B. Stiehl |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty Wound therapy Heel integumentary system Pressure injury business.industry 030208 emergency & critical care medicine Dermatology INFECTIOUS PROCESS medicine.disease Surgery Wound irrigation 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Diabetes mellitus medicine Etiology business Very high risk |
| Zdroj: | Advances in Skin & Wound Care. 33:1-5 |
| ISSN: | 1538-8654 1527-7941 |
| DOI: | 10.1097/01.asw.0000717896.88988.43 |
| Popis: | Stalled healing in chronic wounds is a challenging problem for providers and remains multifactorial in etiology. Older adults with insulin-dependent diabetes are at very high risk. In this case report, two patients with large nonhealing wounds were considered for treatment with daily jet lavage irrigation in an attempt to remove the inflammatory products of their respective chronic wounds and eliminate the persisting biofilm bacteria. Several attempts were made to reduce treatments to two to three times per week, and negative-pressure wound therapy was initiated in both cases only to see the return of inflammation and necrosis of the wound bed. In both cases, the daily jet lavage irrigation was successful in creating a granulating wound bed that slowly healed over many months. One patient died with an open sacral pressure injury, and the other patient died 4 months after complete healing of a large heel pressure injury. The interesting observation is the necessity of daily high-intensity wound irrigation to correct the chronic infectious process. Diabetic chronic wounds in high-risk older adults are recalcitrant to standard wound treatments, and providers should consider daily jet lavage wound irrigation to deal with this problem. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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