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The Many Benefits of Eakin Wound Pouches

Author: Lydia Kruit, South Africa, Stomaltherapist.

This case study looks at how Eakin Wound Pouches can improve a cancer patient’s quality of life after a laparotomy wound dehisced shortly after surgery.

Patient background

  • Mr. Naude is a 57 year old white, afrikaans, medium built male from Stellenbosch, Cape Town, South Africa.
  • He is married with 2 children in high school.
  • He is a professional engineer at the CSIR Built Environment Stellenbosch.
  • There is a family history of colon cancer and his father died of the illness in his mid fifties.
  • Mr. Naude went for a colonoscopy every 2 years to a surgeon.
  • He is a non drinker and a non smoker.

 

Patient’s Calendar of Events

 

 Date  Signs & Symptoms  Investigation    Treatment
1 August 2007 • Blood in his stool with every bowel action
• Bloated stomach
• Losing weight
• General malaise, not feeling well
• Constipation and diahorrea on and off
• Could not climb stairs as he was “JUST TOO TIRED” 		• Gastroscopy and colonoscopy – Normal             • Patient was treated for iron deficiency
2 January 2008 • Still has all of the symptoms as mentioned above. • Colonoscopy revealed no abnormalities • Treated for iron deficiency
3 March 2009 • Still experiencing the same symptoms • Colonoscopy
4 March 2009 

• Petscan done
• Taking 2-3 photos of the small intestine every second – cost R10 000
• Scan took 7 hours to carry out
• No diagnosis made.
• SYMPTOMS GETTING WORSE!
5 May 2009 • Blood transfusion given
6 July 2009 • Colonoscopy carried out with an EXTRA LONG SCOPE.
• Discovered a slow growing tumour just at the ceacum
• Mr. Naude’s colon is 30cm longer than the average person, therefore general scopes were too short for his colon examination.
7 July 2009 • Laparotomy and colectomy done discovering METASTISIES TO THE LIVER AND IN ALL THE SURROUNDING LYMPH NODES.
8 August 2009 • Patient started with aggressive chemotherapy with no effect.
9 Sept 2009 • SERIOUS VOMITTING OCCURED AND PATIENT BROUGHT UP AN 8CM WHITE WORM.
10 Sept 2009 • Patient admitted for total small bowel obstruction.
• Laparotomy performed and obstruction is removed, but Dr warned that the cancer will continue to grow.
• Laparotomy wound dehisced and burst open in the ward.
25 Sept 2009 • Patient is discharged – for palliative care.

 
Nursing care: Plan
  • Pain relief needed - patient was already on Duragesic stickers in an attempt to relieve pain.
  • Get the patient comfortable.
  • Proper wound care specifically to protect surrounding skin, prevent leakage and prevent any odours.
  • Allow mobilisation without leakage.
  • Most importantly, to win the patients trust.
  • Pouching the wound content as well as the stomal efflux.
  • ALSO: general care and rehydration.
  • Lots of support.
 
Pouch selection:

After a thorough assessment it was decided that the following treatment would be best:
  • The wound was cleaned with normal saline and the edges were protected with:
    Eakin Cohesive® Seals
    Eakin Cohesive® Paste 
    Eakin Wound Pouches.
  • The Wound Pouch was changed every 4-5 days.
  • Woundbed tissue was red and fragile.
  • No infection was diagnosed on the wound.
  • Moisture: drained over 67% ++++
  • The Eakin Wound Pouch made a huge difference in managing the huge amount of severely acidic exudate which was yellow pus, green stool, and blood most of the time.
  • Thanks to the Eakin Cohesive® skin protector placed around the entire wound at each pouch change, the wound was almost fully healed within just 3 months!
  • The odour was gone, occluded in the bag.
  • The patient was comfortable and the family were happy.


 

Fig 3Fig 3Fig 2Fig 2Fig 1Fig 1

 

 

 

 

 

 

Fig 6Fig 6Fig 5Fig 5Fig 4Fig 4

 

 

 

 

 

 

 

Fig 7: After 3 monthsFig 7: After 3 months

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Conclusion:

  • The fact that Eakin products were available and were used in the palliative comfort of the patient, made it possible for me, as a Stomaltherapist, to give the patient the most comfortable, pain-free, leak-free, odour-free and lastly worry-free quality time with his family.
  • The patient’s overall physical condition is a factor in determining the risk of the procedures and the individual’s ability to accept it. This patient experienced a positive result through the use of the Eakin products and the aftercare he received.
  • Mr. Naude was able to resume some of his computer work and was creating his own website with family and friends.