Case Report

Using a Bedside Video-assisted Test Tube Test to Assess Stoma Viability: A Report of 4 Cases

Abstract

Mucosal discoloration of an intestinal stoma may indicate self-limited venous congestion or necrosis necessitating operative revision. A common bedside technique to assess stoma viability is the “test tube test”....

Polymeric Membrane Dressings for Topical Wound Management of Patients With Infected Wounds in a Challenging Environment: A Protocol With 3 Case Examples

Abstract

Patients with acute wounds often delay seeking medical assistance until an incapacitating infection has developed. When such patients come for help at a remote Christian clinic in northern Ghana, West Africa, the goals of care are to resolve and prevent a return of infection, decrease pain, enable an immediate return to normal activities, and facilitate healing. Because the local protocol of care, Edinburgh University Solution of Lime (EUSOL)-soaked gauze, did not meet these goals, the author tried using a variety of donated wound dressing regimens....

Management of a Dehisced Hand Wound Using Hydrogen Peroxide, Electrical Stimulation, Silver-containing Dressings, and Compression: A Case Study

Abstract: Wound dehiscence is the separation of a wound along surgical sutures. A 57-year-old, otherwise healthy mechanic presented with a large open wound of >1 month duration on his left hand. His wound had dehisced after treatment that involved cleansing, surgical sutures, and oral antibiotics. He presented with a 5.0 cm x 0.7 cm x 0.3 cm lesion through the palmar creases of the hand with edema around the fourth and fifth digits and a callous formation around the distal portion of the wound. ...

Using Active Leptospermum Honey in the Debridement Process: 6 Challenging Cases from the Inner City

Abstract

  The use of honey-based dressings has been documented for thousands of years. Recent studies suggest their effectiveness may be, in part, related to their ability to facilitate autolytic debridement....

Squamous Cell Carcinoma Arising from a Recurrent Ischial Pressure Ulcer: A Case Report

Abstract

  Marjolin’s ulcer is the malignant transformation of long-standing chronic pressure ulcers and requires prompt diagnosis and treatment. A 46-year-old man with an 8-year history of traumatic spinal injury with paraplegia presented with a recurrent ischial pressure ulcer....

Clinician Challenges in Providing Health Care for a Morbidly Obese Family Member: A Bariatric Case Study

Abstract

  Morbid obesity is a chronic disease affecting millions of Americans. The disorder is likely to increase in prevalence because currently one third of the American population is obese....

Using Medical Silicone to Ensure an Airtight Negative Pressure Wound Therapy Dressing Seal in Challenging Wounds: A Case Series

Abstract

  Negative pressure wound therapy (NPWT) has been used for a broad range of indications and wound types. However, it can be difficult to maintain an airtight dressing seal when the wound is located in an anatomically challenging area or environment. To address this problem, medical silicone, used to create intraoral vacuum dressings, was used in five patients (one woman, four men, age range 57 to 66 years) to seal leaking NPWT dressings (four polyurethane dressings and one polyurethane silver foam dressing)....

Transcutaenous Electrical Nerve Stimulation to Manage a Lower Extremity Wound Complicated by Peripheral Arterial Disease: A Case Report

Transcutaneous electrical nerve stimulation (TENS) is used to alleviate muscle pain, and there is some evidence it may affect healing in chronic wounds. An 80-year-old male patient with a chronic left lower extremity wound and a history of peripheral arterial disease, type 2 diabetes, hypertension, chronic obstructive pulmonary disease, and lung cancer presented for treatment. Previous protocols of care, mainly consisting of sharp debridement and daily dressing changes, had not resulted in a decrease in wound size....

Treating Peristomal Pyoderma Gangrenosum With Topical Crushed Prednisone: A Report of Three Cases

The main goals of treating peristomal pyoderma gangrenosum (PPG) — ulcerations in the stomal area — are to decrease pain, increase pouch adherence, and decrease pyoderma. The literature suggests a wide variety of approaches to achieve this goal, but few studies report outcomes on the use of topical steroids. The purpose of this case study is to describe the results of a protocol developed to meet the goals of care for patients with PPG....

Considerations for Diagnosis and Management of Ileostomy-related Malignancy: A Report of Two Cases

Abstract

  Malignancy associated with a long-standing ileostomy is a rare occurrence reported as early as 3 years after ileostomy placement. Patients most commonly present first to their ostomy care nurse with peristomal skin changes unresponsive to conservative measures. To elucidate presentation and management, two cases of male patients with ileostomy-related with malignancy (one lymphoma and one squamous cell carcinoma) are discussed. ...