Background: Alginate dressings manage wounds with moderate to heavy exudate, interacting with exudate to form a soft gel to maintain moist healing. When managing granulating wounds with less exudate, complications can occur: adhesion, trauma with dressing removal, desiccation and pain. Three patients with slow healing wounds were originally managed with alginate silver dressings, but experienced complications which impeded wound contraction and epithelialization. Patient 1: Diabetic foot ulcer, Patient 2: Stage 4 below knee medical device related pressure injury associated with negative pressure wound therapy (NPWT), Patient 3: Abdominal surgical wound tummy tuck infection.
Methods: Patients were referred to an outpatient wound specialist,1x week and seen by home health 2x week. Wound management was changed to Polymeric Membrane Dressing (PMD) with or without silver and extra-thick for large exudate. Wounds were cleansed with sterile water at dressing changes per standard home health wound care orders. PMD was compared to alginate silver utilizing the criteria: 1. Drainage Management- absorbency and moist wound management 2. Bio Burden Control-Prevention of critical colonization 3. Peri-Wound skin protection- Prevent maceration, hyperkeratosis, erosion. 4. Wound Bed Protection- shear, friction, pressure.
Results: Patient 1: 100% re-epithelialization within 24 weeks. Patient 2 and 3: 100% re-epithelialization within 12 weeks. With PMDs: 1. Drainage Management- PMD had optimal moist wound bed management, absorbency and did not stick to the wound. 2. PMD silver provided bioburden control and prevented critical colonization. With no trauma to the wound, there was prevention of activating inflammation and pain with dressing changes. 3. Peri-Wound skin protection-Decreased callous formation with PMDs compared to alginate and less need for serial debridement. No maceration, hyperkeratosis, erosion developed 4. PMDs protected the wound bed from shear, friction, pressure.
Conclusions: All patients’ wounds closed with PMDs with no complications experienced as with calcium alginate.