Background Wound infection diagnosis should be based on signs and symptoms of wound and surrounding skin such as exudate, bleeding surface, necrotic tissue, smell, erythema and oedema. The evaluation of local signs and the clinical evaluation of the patient are important to decide the best treatment.
Purpose To investigate clinical records regarding the wound, local signs of infection and antimicrobial treatment in patients with silver dressings.
Material and methods A retrospective observational epidemiological study was conducted between January and July 2014. All patients with prescriptions for silver dressings were identified using the Pharmacy systems Hosix and Sivsa. Data from clinical records were collected from Soarian and recorded in Excel. Data were analysed using SPSS.
Results We identified 62 patients with silver dressings (66.1% male; average age 71.1). Silver dressings were prescribed mainly for surgical wounds (27.4%) and stage 4 pressure ulcers (27.4%). The average length of treatment was 20.9 days. Rubor of the skin around the wound in 40.3% of wounds and purulent exudate in 67.7% were the main signs of infection identified. Necrotic tissue that can encourage bacterial growth was found in 85.5% of the wounds. In 25.8% of the patients, nurses used an antiseptic solution to clean the wound between dressings. Systemic antimicrobials were prescribed in 79% of patients, 53.2% of whom had a diagnosis of wound infection. The group of patients to whom antiseptics were administered locally had fewer days of treatment with silver dressing, although it was not statistically significant (p = 0.26). Also, the group of patients with prescriptions for silver dressings for longer than 10 days was statistically associated with wound complications (p = 0.05).
Conclusion All patients had clinical signs of wound infection that supported the use of silver dressings and most of them (79%) also needed systemic antibiotic treatment. We found it crucial that clinical records should be more complete regarding odour, local pain, oedema and other local signs.
References and/or Acknowledgements No conflict of interest.
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