| Purulence/Infection
POD 0-12 |
|
Remove all signs of possible purulence
- Aspirate or evacuate by incising/rolling
- Treat with topical antimicrobials - Irrigate INTEGRA™
Matrix Wound Dressing sites at seams/edges and beneath
the silicone layer of INTEGRA™ Bilayer Matrix Wound Dressing with a topical antimicrobial such as sulfamylon
5 solution/slurry, G-U irrigant, or silver nitrate 0.5%
solution. Irrigate frequently (2-6 times daily).
- Culture and initiate systemic antibiotics based on the
clinical judgement of the practitioner
If aggressive treatment of purulence
is not successful as evidenced by increasing purulence/pus,
non-take of INTEGRA™ Matrix Wound Dressing (i.e.,
a "floating" sheet) or silicone separation of
INTEGRA™ Bilayer Matrix Wound Dressing, then the
affected area needs to be removed.
- Remove only the affected area using "windowing"
(remove dressing over area to be treated, creating a "window"),
treat with topical antibiotics
- Treat as open wound until infection is resolved. Once
infection is resolved, apply new INTEGRA™ sheet or
treat with temporary covers. If applying an epidermal
autograft, the granulation tissue should be removed, revealing
healing tissue underneath.
Areas of Incomplete INTEGRA™
Matrix Wound Dressing Take (i.e., inadequate formation)
POD 5 or higher
Areas of incomplete take or detachment of the INTEGRA™
Matrix Wound Dressing can result from mechanical dislodgement
(due to shear, improper splinting, PT), infection, hematoma,
granulation tissue formation, premature silicone separation
(when used with INTEGRA™ Bilayer Matrix Wound Dressing)
or damaged matrix.
There are several options for treating areas of incomplete
take depending on the size of the area:
- Areas under 2 sq cm should be monitored for infection
but not remove until time of epidermal grafting
- Areas over 2 sq cm should be removed and treated by
either (1) re-application of new INTEGRA™ Dressing
or (2) STSG
- Identification of poor INTEGRA™ Matrix Wound Dressing
take is identified by poor color and lack of adherence
(lateral movement of matrix under finger pressure)
