This case study looks at the management of a complex and uneven wound.

Submitted by: Sarah Haughey, RGN BSc, Belfast, Northern Ireland

Patient History

62-year-old lady with a long history of Crohn’s Disease. She has had multiple small bowel resections over the past 20 years. She was admitted to hospital for a mesh repair of a large incisional hernia.

She developed intra-abdominal sepsis and returned to surgery for a laparotomy and excision of perforated small bowel. The surgical team were unable to close the abdominal wound and the lady remained in hospital for six months due to her complex needs.

Care Management Plan

• Whilst in hospital, the eakin Wound Pouch™ was used successfully and routinely.

• Family wished to be involved in all aspects of care after the patient was discharged home.

• Family were having trouble applying the eakin Wound Pouch^TM.

• It was found that a combination of factors had contributed to the leakages.

The nurse specialist used the discussion as an opportunity to teach the basics of wound management to ensure a more confident family and community team combination.

Process

Here you will see the steps taken by the nurse specialist to minimise leakage around the wound opening and improve the lady’s quality of life.

1. Periwound area cleansed with normal saline and dried with gauze.

2. Powder is applied to excoriated skin.

3. small eakin Cohesive^® seal is broken into pieces and inserted into deep creases to obtain an optimal level skin surface.

4. eakin Wound Pouch™ applied to the area and connected to continuous drainage due to the high output nature of the wound.

The lady is now achieving extended wear time from each eakin Wound Pouch™ and is still able to be managed at home via a combination of community nursing and family care.

Outcome

• Combination of care provided by family and nursing team.

• Connected to continuous drainage.

• Longwear time achieved.

• No leakage occurring.

• Lady able to be managed at home.

• 3 days wear time achieved from the eakin Wound Pouch™.

• Lady discharged from hospital.