The early complex wound approach in an emergency unit: a successful experience

Abstract

Complex wound is the term used to identify the wound that are very difficult to heal. The early approach impacts on the service, leading to a shorter admission time, reducing health problems and admission costs. Goal: Report an early wound approach, caused by post-traumatic erysipela bullosa. Method: it is a case report, carried out at Referred Emergency Unit. Result: Female patient, 63 years old, admitted at REU after being victim of trampling with trauma in left lower limb and tibia and fibula fracture, evolved with edema and one day after her admission, started a hyperemia condition, pain and bullous lesions. She was assessed by nurses and underwent to early conservative instrument debridement of the necrotic tissue from the bullous lesion and topical therapy with 0.2% PHMB Solution, non-adherent bandage, exchanged every 3 days, and zinc oxide in edges. Ten days after her admission, the lesions measured (lesion 1) 9x18 cm and (lesion 2) 3x2.5 cm. The following day, the patient was referred to the Surgical Center, and subsequently, to the ward. She was discharged two days after that. The patient attended REU later for reassessment, with both lesions already epithelialized. Discussion: –The early proper approach performed enabled the granulation tissue growth and the complete epithelialization of both wounds in a short time span. Conclusion: The care with complex wounds must be widely discussed in the emergency services, in order to promote an excellent nursing care.