Title

APWCA2009 - Apr 04, 2009

Author(s)
 

Presented at: Philadelphia, PA

Background
A 74-year-old male developed a draining infection in an old AV graft adjacent to his active dialysis site. Antibiotics were unsuccessful, so the infected graft portion was surgically removed, leaving two incisions and a large, at-risk cavity. Conventional packing materials have no special therapeutic properties and have limited wicking abilities. Silver polymeric membrane rope cavity filler wicks well, inserts and removes easily, continuously cleanses, is antimicrobial, and inhibits the nociceptor response, which often results in dramatic pain relief.

Methods
Two cut pieces of silver polymeric membrane rope cavity filler were placed side-by-side in the cavity which extended from one incision to the other. Two more pieces (from the same package) filled the cavity distal to the second incision. Stretch gauze held gauze secondary dressings in place. The patient replaced gauze as needed. Rope was replaced every 37 days. No wound cleansing was done at dressing changes. Systemic antibiotics were avoided.

Results
The silver rope effectively cleared infection and allowed rapid cavity contraction and closure. The patient experienced no wound pain, even during rope dressing changes. Granulation tissue was visible at the first dressing change. After 3½ weeks, the rope dressing was discontinued; the cavity immediately sealed shut.

Conclusion
The new silver polymeric membrane rope cavity filler maintained appropriate moisture in the wounds while simultaneously wicking away wound drainage and allowing rapid wound healing and clearing of the infection. The rope was easy to insert and remove. Patient comfort while in place and at dressing changes was outstanding.