Appropriate wound dressing?

Patient is a 45yo M. S/p I&D on 12/29 due to Fournier’s gangrene. Patient was on multiple IV antibiotics. Current WC orders by general surgery is wet to dry dressing. There is moderate amount of drainage from the wound. Patient is for discharge tomorrow.

Jan 8, 2025 by Kristine Pasco, DNP, MPH, APRN, FNP-BC

1 replies

Elaine Horibe Song
MD, PhD, MBA

Hi Kristine

Thank you for your question. Other colleagues might have additional suggestions, but summarized below are thoughts shared by our clinical advisor Scott Robinson, MD:

It's a challenging location, but if available and if a good seal could be achieved, NPWT would be a good first option, even if it's for a few days. If not possible, another option is to loosely pack the wound with antimicrobial packing gauze (e.g. Algidex Ag). If not possible, another alternative would be to use other antimicrobial dressings as primary dressing (e.g Promogran Prisma, Hydrofera Blue, etc). Prior to dressing application, any necrotic tissue or debris should be adequately debrided if no contraindications are present.

Additional resources:

Curbside Consults:

https://woundreference.com/app/post?id=833
https://woundreference.com/app/post?id=313
https://woundreference.com/app/post?id=664
https://woundreference.com/app/post?id=1186

https://woundreference.com/app/topic?id=dressing-brands-quick-summary&find=prisma

Hope this helps!

Jan 9, 2025

* Information provided without clinical evaluation and is not intended as a replacement for in-person consultation with a medical professional. The information provided through Curbside Consult is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.

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