One Eakin Maxi Wound Pouch™ solves the Problem
This case study examines the role of one single Wound Pouch™ with Release™ Adhesive Remover in significantly improving patient comfort
Submitted by: Nicole Wienhold, RN, Abenraa Sygehus, Denmark.
• 2010- 61 year old woman had a hysterectomy performed but surgery was complicated by a perforation of the sigmoid colon and a stoma was created.
• Due to obesity the abdominal scar ruptured and was treated with VAC therapy.
• 2011- a parastomal hernia developed.
• The wound was well managed by homecare nurse team.
The patient was worried about undergoing surgery to close the stoma and the wound. However, after careful consideration and evaluation, the decision was made to proceed with some plastic surgical assistance.
• 7 days post-operative, the wound dehisced. The lady developed severe sepsis and was admitted to the Intensive Care Unit.
• She developed an enterocutaneous fistula.
• Further surgery was carried out to close the stoma and the wound, but the fistula was not touched.
The lady has short bowel syndrome and has a central vein catheter to receive parenteral nutrition. She is NIDDM (Non-Insulin-Dependent Diabetes Mellitus) with unstable blood sugar.
The two Coloplast Fistula Pouches were found to be very rigid (Fig. 1), which meant when the patient moved, they leaked. Mobility is severely restricted due to frequent leakages.
Prior to removing the two Fistula Pouches, pain relief had to be administered to the patient. Morphine was given intravenously in advance of the wound dressing, as the pain was unbearable, even when using Welland Adhesive Remover Spray.
Care Management Plan
Eakin Release™ Adhesive Remover Spray was recommended and even before the medication could take effect, the pouches were removed from her skin without any pain experienced. Fig. 2 shows the wound uncovered.
The patient’s large wound had deep cavities to the left and right. To avoid the accumulation of output (>2,000ml/24 hours), a Foley catheter was inserted into the fistula and the tube was allowed to drain out of the bung in the Wound Pouch™ into a drainage bag, which remained attached at all times.
• Tracing guide used to draw the shape of the wound (Fig. 3).
• Wound Pouch™ prepared.
• One Eakin Maxi Wound Pouch™ was a perfect fit for this big wound.
• The wound was picture framed (Fig. 4) with Eakin Cohesive® Skin Barriers cut in two long strips with small slits in one side to make it flexible around the wound.
• Eakin Maxi Wound Pouch™ applied to the wound (Fig. 5).