A 34-year-old male patient, with no relevant personal and family history of the disease.
He takes care of his own fast food business, so he is standing around 6 h a day.
She was evaluated by the angiology service where she was diagnosed with mixed ulcer in the left lower limb.
Culture of ulcer secretion is positive for Escherichia coli.
The patient is referred to the infectious diseases area where antimicrobial therapy is indicated.
Upon admission to the wound clinic, a patient with severe pain (10 by analog scale) in the left lower limb was observed.
Extremity with presence of edema up to the middle third, occreation of the lower tibial region, pulses present, capillary refill 3 3, long tibial fill with anterior tibialis longus, and purulent discharge area cm.
In October 2013, the wound was healed with traditional therapy, under the following scheme: the gauze covering the wound was moistened with solution for irrigation in order to facilitate its presence, to the extent possible.
Once the gauze was removed, the wound was assessed using the RESVECH 1.0.6 index (the collected data were captured in Excel for further analysis).
Then, the wound was cleaned following the basic rules of asepsis and antisepsis, sterile gauze, antiseptic soap and solution for sterile irrigation were used.
Once the wound was clean, it was dried and covered with sterile gauze, which were secured with a compression bandage.
This procedure was performed daily, 5 days a week, for 5 months (October 2013 to March 2014); however, the wound showed no significant progress, only an increase in necrotic tissue was observed.
From April 2014, the wound was treated with a moist wound healing.
Under this scheme, dressings were performed twice a week during the first 3 months of treatment; during the subsequent months, the procedure was performed once a week.
This type of therapy was applied during a period of 5 months (April-September 2014), following the procedure described below: prior to each healing, wound assessment was performed based on the RESVECH wound healing index.
Physiological saline solution and antiseptic spray were used to wash the wound. In the presence of necrotic tissue, a gel was applied for the autolytic debridement without pain and bleeding.
As a secondary dressing, a hydrochlorothiazide was used, which was changed every 24 hours due to excess moisture in the wound.
At the end of each healing, a compression bandage was applied.
In total 130 cures were performed with traditional therapy lasting approximately 60 min each, while with the therapy in humid environment 62 cures were performed with a total duration of 20 min each of the traditional nursing care 130.
With traditional therapy, the wound did not show healing data, its conditions and evolution remained in the same status throughout the period, while with the therapy in humid environment there were positive results in promoting wound healing 5 months.
1.
We also calculated the daily cost of wound healing with wet environment therapy versus traditional therapy using the formula proposed by Soldevilla et al.6: Daily cost = daily frequency of dressing change × cost of dressing change.
The results show that the cost of cure with moist environment therapy is higher compared to traditional therapy.
It can also be observed that the cost of nursing time with traditional therapy exceeds the time of nurse in healing with therapy in a moist environment.
