{"title":"Negative Pressure Wound Therapy With Instillation as an Early Intervention for Extensive Wounds From Necrotizing Fasciitis: A Case Study.","authors":"Beth A Myers","doi":"10.1097/WON.0000000000001101","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Ms. S was a 50-year-old woman hospitalized with necrotizing fasciitis from a labial abscess. After several surgical interventions wound debridements were performed consecutively for 6 days. She was left with extensive full thickness tissue destruction of her abdomen, bilateral groin areas, and complete displacement of skin over her mons pubis. Wounds related to necrotizing fasciitis can be especially challenging to manage, especially when the perineal region is involved. Due to the location of such wounds, it can be difficult to maintain dressings, including negative pressure wound therapy with instillation devices (NPWTi). Ms. S. also had a history of uncontrolled diabetes mellitus, which can hinder wound healing.</p><p><strong>Case: </strong>The Wound, Ostomy and Continence (WOC) nurse was consulted on day 6 of Ms. S's admission, for application of NPWTi. Complex NPWTi dressings were completed in the operating room (OR), 2 times weekly for 2 weeks. When Ms. S was transferred from the intensive care unit to the surgical unit, NPWT dressings with instillation were used but later converted to standard NPWT, changed twice weekly by the WOC nurse. Dressings were changed at the bedside until day 29 of her admission.</p><p><strong>Conclusion: </strong>The management of Ms. S's extensive wounds was successful, and her wounds were closed by plastic surgery on day 29 of her admission. Ms. S was the first patient at our hospital with extensive wounds from necrotizing fasciitis to undergo surgical closure of her wounds during the same hospital admission.</p>","PeriodicalId":49950,"journal":{"name":"Journal of Wound Ostomy and Continence Nursing","volume":"51 6","pages":"499-506"},"PeriodicalIF":1.7000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Wound Ostomy and Continence Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/WON.0000000000001101","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/12 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Ms. S was a 50-year-old woman hospitalized with necrotizing fasciitis from a labial abscess. After several surgical interventions wound debridements were performed consecutively for 6 days. She was left with extensive full thickness tissue destruction of her abdomen, bilateral groin areas, and complete displacement of skin over her mons pubis. Wounds related to necrotizing fasciitis can be especially challenging to manage, especially when the perineal region is involved. Due to the location of such wounds, it can be difficult to maintain dressings, including negative pressure wound therapy with instillation devices (NPWTi). Ms. S. also had a history of uncontrolled diabetes mellitus, which can hinder wound healing.
Case: The Wound, Ostomy and Continence (WOC) nurse was consulted on day 6 of Ms. S's admission, for application of NPWTi. Complex NPWTi dressings were completed in the operating room (OR), 2 times weekly for 2 weeks. When Ms. S was transferred from the intensive care unit to the surgical unit, NPWT dressings with instillation were used but later converted to standard NPWT, changed twice weekly by the WOC nurse. Dressings were changed at the bedside until day 29 of her admission.
Conclusion: The management of Ms. S's extensive wounds was successful, and her wounds were closed by plastic surgery on day 29 of her admission. Ms. S was the first patient at our hospital with extensive wounds from necrotizing fasciitis to undergo surgical closure of her wounds during the same hospital admission.
期刊介绍:
The Journal of Wound, Ostomy and Continence Nursing (JWOCN), the official journal of the Wound, Ostomy and Continence Nurses Society™ (WOCN®), is the premier publication for wound, ostomy and continence practice and research. The Journal’s mission is to publish current best evidence and original research to guide the delivery of expert health care.
The WOCN Society is a professional nursing society which supports its members by promoting educational, clinical and research opportunities to advance the practice and guide the delivery of expert health care to individuals with wounds, ostomies and continence care needs.