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POSTER: CASE STUDY<br />
Poster: Case Study<br />
P 398<br />
ExP erience Using P olymeric Membrane Dressing Circumferential<br />
WraP Technique in 120 Total Knee ArthroP lasty (TKA) Cases<br />
Amran Ahmed Shorki 1<br />
1 Universiti Sains Malaysia, Kelantan (Kota Bharu, Malaysia).<br />
Total knee arthroplasty (TKA) infections eliminated and rehabilitation improved using<br />
polymeric membrane dressing circumferential wrap technique: 120 patients at 12 month<br />
follow-up<br />
Objectives: Reduce the infection rate after total knee arthroplasty (TKA) from 7%<br />
towards 0% by moving from gauze to a system consisting of polymeric membrane<br />
dressings (PMDs) and polymeric membrane wraps (PMWs). Evaluate the reduction of<br />
inflammation and swelling by use of this system.<br />
Methods: 120 severe TKA patients were studied over an 18-month period. PMDs with<br />
film-adhesive were applied in theatre over incision site, and knee wrapped with nonsterile<br />
PMW. Four days post-operatively dressing change was performed.<br />
Circumferential swelling (around mid-line patella) and pain (VAS) measurements were<br />
taken day five. Post-operative physical therapy rehabilitation took place three times per<br />
week for six weeks. Wraps were replaced weekly and continued though rehabilitation.<br />
Movement measurements made according to KSS and LEFS.<br />
Results: Post-operative swelling was reduced by 20% (average). Pain was reduced<br />
from score 6.5 to 3 (VAS). Wounds were often fully epithelialized at day 3 vs. previously<br />
day 5, reducing the risk of infection introduction during dressing changes. Zero infections<br />
during the entire 12-months. This stayed at 0 % for patients followed up at 18-months.<br />
Rehabilitation was also improved through reduced pain and inflammation for the<br />
patients, allowing them to complete their strengthening program more effectively.<br />
Conclusion: PMDs and wrap technique seems to eliminate wound breakdown and<br />
post-operative joint-infection, while at the same time significantly reducing patients’ pain.<br />
Reduction in inflammation and swelling improved rehabilitation compared to previous<br />
protocols. While this is very encouraging a more statistically valid conclusion must/will<br />
be sought through a RCT.<br />
P 399<br />
Poster: Case Study<br />
CLINICAL CASE WITH VENOUS ULCER AND TREATMENT bacterial biofilm<br />
dressing + PHMB RINGER<br />
Federico Palomar Llatas 1 , Concepcion Sierra Talamantes 1 , Begoña Fornes Pujalte 1 ,<br />
Victor Lucha Fermandez 1 , Lydia Landete Belda 1 , Paula Diez Fornes 1<br />
1 Hospital General Universitario y Universidad Catolica de Valencia (Valencia, Spain).<br />
Summary: The bacterial biofilm called, is an entity characterized by its aggressiveness<br />
and host progressive inability to cope and to restore autoimmunity polymicrobial<br />
defensive towards this medium. Making this bacterial biofilm deposited on the bed of the<br />
more chronic wounds still hinder healing. Our case is based on moist wound healing,<br />
keep getting autolytic debridement, osmotic, irrigation and bacterial biofilm destruction,<br />
controlling the inflammatory process and that in turn leads to increased exudates.<br />
We report the case of a patient of 80 years with ulcer in the lower third of the leg edema<br />
of the entire leg injury and 7 x 6 and 12 months old, with no history: No diabetes, no<br />
dyslipidemia<br />
Aim: Eliminate bacterial biofilm<br />
Control of exudate<br />
Reset the healing process<br />
Methods:<br />
– Biofilma chronic wound bacteria according to their clinical characteristics and without<br />
showing the classic signs of infection<br />
– Debridement saline<br />
– Biofilm cortantante Debridement<br />
– Transfer to microbiology bacterial biofilm<br />
– Cream periwound skin protection with Zn oxide barrier<br />
– Ringer dressing application PHMB<br />
– Protection with foam dressing<br />
– Compression bandage with short stretch bandages<br />
– When dressing change at 3 days is done with tissue other crop<br />
Results:<br />
– Pretreatment: S aureus 7000 UFC/gr tejido<br />
– P aeroginosa 5000 UFC/gr tejido<br />
– S marcescens 8000 UFC/ gr tejido<br />
– Post treatment: microbiology cultures negative<br />
Conclusions:<br />
– Elimination of bacterial biofilm<br />
– Wound healing<br />
– Preventive treatment co Compression Stockings<br />
<strong>EWMA</strong> <strong>2013</strong><br />
COPENHAGEN<br />
15-17 May · <strong>2013</strong><br />
Danish Wound<br />
Healing Society<br />
229
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