Treatment and care of a post-traumatic wound

Abstract

Aim: Treatment of a post-traumatic wound in a case of a complicated wound healing. Method: 55-year-old man experienced domestic trauma with a circular saw, the long extensor tendon of the first digit of left foot was injuried. The patient had a reconstructive surgery of tendon insertion and reconstruction. 2 weeks after the surgery, foot got inflammated, necrosis on a dorsal part appeared. Patient was consulted by a plastic surgeon for further treatment, hospitalisation and surgical treatment were advised. In the treatment course, abondant fibrin layer covered the dorsal part of the foot, whole foot was inflamed. Wound smear revealed growth of S. Aureus, adequate antibiotherapy with intravenous Cefazoline 1g 3 times a day was prescribed. Conservative treatment with running water and Octenidine soap was applied. Circulation improving medicine - Pentoxifylline 600mg 2 times a day and compressive therapy were given. After one week of treatment, amorphous hydrogel dressing*1 and advanced hydrocolloid dressing*2 were chosen. Two weeks following this treatment wound covered in granulation tissue, wound borders started to epithelialize, further treatment with multi-layered hydrocellular foam dressing*3 was continued for 2 weeks. After 3 weeks of treatment wounds healed completely. Further rehabilitation and physiotherapy were continued. Conservative treatment and skin hydration with emolients were recommended. Results / Discussion: Wound epithelialization and healing were achieved. Patient was able to return to his normal life, foot function was restored completely. Conclusion: Qualified and adequate care of post-traumatic wounds, especially in a case of anatomical structure injury, is crucial to preserve normal function.