title: Management of a Dehisced Hand Wound Using Hydrogen Peroxide, Electrical Stimulation, Silver-containing Dressings, and Compression: A Case Study.
abstract: Wound dehiscence is the separation of a wound along surgical sutures. A 57-year-old, otherwise healthy mechanic presented with a large open wound of >1 month duration on his left hand. His wound had dehisced after treatment that involved cleansing, surgical sutures, and oral antibiotics. He presented with a 5.0 cmx0.7 cmx0.3 cm lesion through the palmar creases of the hand with edema around the fourth and fifth digits and a callous formation around the distal portion of the wound. The wound had scant serosanguinous drainage and some induration at the periwound area, as well as a moderate foul odor. Tendons were not affected, but function was limited, the hand was painful, and the patient had been unable to work. Treatment was initiated with twice-a-week immersion of the hand in hydrogen peroxide diluted with water subjected to high-voltage pulsed current electric stimulation (HVPC). The wound was dressed with silver-containing dressings secured with stretch gauze and a compression garment. The wound was completely closed after 9 visits (35 days). No functional limitations of the hand or fingers, no cosmetic defect, and no wound recurrence were noted 9 months after healing. Although uncommon, dehisced wounds, especially in certain anatomical locations such as the hand, can be difficult to heal and may cause long-term problems with functioning. The treatment combination facilitated expedient healing of this dehisced hand wound. Research is needed to help elucidate the observations from this case study.
authors.affiliation: Department of Health Care Studies, Daemen CollegePlease address correspondence to: Kehua Zhou, MD, DPT, LAc, Daemen College, 4380 Main Street, Amherst, NY 14226; email: kzhou@daemen.edu.
authors.forename: Kehua
authors.initials: K
authors.lastname: Zhou
authors.affiliation: Daemen College Physical Therapy Wound Care Clinic, Cheektowaga, NY.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Krug
authors.affiliation: Department of Physical Therapy, Daemen College.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Brogan
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001458:Bandages; D004599:Electric Stimulation Therapy; D006230:Hand Injuries / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006801:Humans; D006861:Hydrogen Peroxide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011095:Polyethylenes; D011140:Polyurethanes; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000473:pathology / Q000628:therapy*
chemical_list: C117408:Acticoat; D000891:Anti-Infective Agents, Local; D011091:Polyesters; D011095:Polyethylenes; D011140:Polyurethanes; C081143:allevyn; D006861:Hydrogen Peroxide