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Case Study #5 - FV Xcell Antimicrobial Utilization
04/23/03 16 year old Hispanic male with Spinal bifida with loss of sensory and most motor activity presents to clinic with chronic neurogenic ulcer ulceration to the plantar left hallux non-healing wound which has been present since 12/18/02 Soft tissue swelling is present underlying the base of the great toe. X-Rays on a lateral radiograph show no underlying cortical destruction or periosteal reaction. No evidence of osteomyelitis is present. Today the patient is shown how to perform local wound care, the simplest method to be used for 1 week using sterile normal saline, gauze, and Coban lightly applied x 2 daily. Also discussed is possible outpatient surgery to excise wound and culture wound site and possibly close the wound.
There is no resolve of the wound and on 05/12/2003 patient and guardian are scheduled for pre-operative visit for out-patient surgery on 05/16/04. Due to continued transportation issues patient misses 05/12/03 pre-operative visit and is rescheduled for 05/27/03. Outpatient surgical procedure is performed on 05/30/03.
Patient develops a post surgical infected abscess and is return to OR on 06/04/03 and condition is resolved. He is placed on oral antibiotics and a home health nurse is assigned to him to render daily wound care. Weekly post operative visits continue from 06/09/03 through to 08/13/03 when the wound has complete closure.
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10/02/03 - patient and guardian return to clinic. The patient states that the ulcer has returned several weeks ago after he started going swimming again. |
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Wound is sharp debrided and the patient is placed on wound care utilizing Xcell Antimicrobial Wound Dressing with weekly in clinic follow up and home health care nursing assistance for dressing changes every three days. Wound tissue has been cultured and a topical skin infection is present preventing and/or stalling the wound. |
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Photo represents wound state after dressing removal post 1 week utilization of Xcell Antimicrobial. |
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Above photo represents wound state post debridement after 15 days of utilization of Xcell Antimicrobial Wound Dressing with dressing change every other day for the past 8 days. |
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Photo represents wound state post debridement after 3 weeks of utilization of Xcell Antimicrobial Wound Dressing. There has been no sign or tissue culture test result to indicate any topical or soft tissue infection in or around wound site since initiation of antimicrobial dressing. In the past, this patient continuously presented with or developed an infection of some level at or in the wound tissue during conservative (wet-to-dry) wound care. |
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Photo represents complete closure of wound site at 5 weeks of utilization of Xcell Antimicrobial Wound Dressing with dressing change every 5 days since last visit 2 weeks ago. The patient was advised to discontinue all dressings, and is discharged from care at this time. The patient has also been advised to wear shoes that have cushioning and padding and to keep his feet dry. The wound has remained intact and no re-ulceration has occurred to date. |
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