Empowering Patients to Manage Their Own Recurrent MRSA Ulcers - An Innovative, Effective Solution
Linda Benskin, PhD, RN, SRN (Ghana), CWCN, CWS - Independent Researcher for Remote & Conflict Areas of Tropical Developing Countries, and Research, Education, & Charity Liaison for Ferris Mfg. Corp.
INTRODUCTION
Challenge: Methicillin resistant staphylococcus aureus
(MRSA) often causes painful, inflamed, deep, narrow
ulcers. Due to COVID-19, face-to-face wound
management has become limited, making self-care
options especially appealing.
Significance: Because MRSA ulcers are often
recurrent, many patients would prefer to manage these
wounds without in-person visits for dressing changes,
even before COVID-19. However, procedural pain and
prescription needs often block this goal.
Solution: All polymeric membrane dressings (PMDs)
relieve pain and control inflammation, continuously
cleanse wounds, and partner with the body to balance
moisture throughout the wound. Because PMDs slide
out easily and control inflammation, dressing changes
are atraumatic and usually so pain-free that patients
can perform them independently. This mesh-reinforced
antimicrobial rope cavity filler remains intact, even
when saturated, making it the logical PMD
configuration choice for MRSA ulcers.
METHODS
After an initial thorough saline irrigation, PMD silver
rope cavity filler is cut-to-fit and inserted into the
narrow tunnel using a standard wooden cotton-tipped
applicator. Excess rope is stored in a freezer zipper-
bag for future dressing changes.
Three example patients are described: a middle-aged
man whose first two MRSA ulcers required
hospitalization for IV antibiotics, and a young man and
young woman, both of whose first MRSA ulcer required
outpatient incision and drainage plus oral antibiotics.
OUTCOMES/RESULTS Example Patient 1 acquired MRSA while incarcerated in a county facility, and kept
getting new ulcers, which led to hospitalizations for IV antibiotics. Then he
Each patient was empowered to provide their own MRSA discovered PMD silver rope. After initial irrigation with saline, he cuts the piece of
rope lengthwise to the appropriate diameter and inserts it into the narrow tunnel.
ulcer care, reducing the burden on the healthcare system Because the PMDs decrease inflammation, this process is not especially painful. He
and decreasing patient burden, as well. PMDs reduced pain continues to manage the recurrent ulcers with PMDs, and states that this method is
not burdensome to him.
and inflammation, allowing each patient to perform their own
Example Patient 2 is a woman who had
dressing changes. The PMD silver rope cavity filler helped recurrent MRSA for several years. The scar
keep the deep, narrow cavities clean, and patients found from the adjacent first elbow ulcer is visible in
the middle photo. She took oral antibiotics, but
them to be completely non-adherent to the wound bed and
did not require incision and drainage. After the
easy to use. Infections consistently cleared quickly, and pain third ulcer, on her cheek, she stopped
was reduced so dramatically that all of the patients were developing them. Initial (Elbow) Second (Elbow) Final (Cheek)
Example Patient 3 is a young officer in juvenile
able to stop taking any pain-relieving medications.
detention, who developed an excruciatingly painful
MRSA ulcer on his calf. After incision and drainage,
Every ulcer each patient developed has closed without
the surgeon packed it with iodine-impregnated
incident using the mesh-reinforced antimicrobial PMDs. The gauze. The persistent wound pain was so great that
the officer required narcotic pain relievers, he could
two young patients used the PMDs until they no longer
not care for the ulcer himself, and he could not work. When he switched to PMDs,
suffered from recurrent MRSA ulcers. The middle-aged he was immediately able to stop taking all pain relievers, change his dressing
independently, and resume working. When he developed a second MRSA ulcer on
patient manages all new ulcers promptly with PMDs. None
his cheek, PMDs facilitated a quick resolution without a surgical consult.
of the patients have had any wound-related complications,
and all have reported consistently quick healing. CONCLUSIONS
Using dressings that safely increase patient independence, with
OBJECTIVES
initial tele-guidance from a health care professional, decreased
1. Reflect upon the advantages to patients and healthcare systems of
patients being able to manage dressing changes independently. the burden of MRSA ulcers on the health care system while
2. Recognize that pain relief and inflammation control are important improving patient satisfaction. PMD silver rope cavity filler
factors in freeing patients to change dressings without assistance. consistently provided an elegant solution for a frustrating, painful,
3. Evaluate the functional attributes of polymeric membrane mesh- wound problem: MRSA ulcers.
reinforced antimicrobial rope with respect to its suitability for patients
who wish to manage MRSA ulcers independently.
REFERENCES
1. Benskin, L. L. (2018). Evidence for Polymeric Membrane Dressings as a Unique Dressing Subcategory, Using Pressure Ulcers as an
DISCUSSION Example. Advances in Wound Care, 7(12), 419–426. https://doi.org/10.1089/wound.2018.0822
2. Tamir, J. (2010, June 13). Surgical Infected Wounds with Deep Narrow Cavity Managed with Silver Rope Dressing [Poster #4381].
Patients performing their own dressing changes have successfully 2010 WOCN/WCET Joint Conference, Phoenix, AZ USA.
https://www.researchgate.net/publication/268106122_Acute_Infected_Cavity_Wounds_treated_with_New_Reinforced_Rope_Dressing
used PMD silver rope cavity filler to manage fistulas and abscesses, 3. Cahn, A., & Kleinman, Y. (2014). A novel approach to the treatment of diabetic foot abscesses—A case series. Journal of Wound
and physicians have reported success using this configuration of Care, 23(8), 394, 396–399. https://doi.org/10.12968/jowc.2014.23.8.394
4. Benskin, L. L. (2012). PolyMem Wic Silver Rope: A Multifunctional Dressing for Decreasing Pain, Swelling, and Inflammation.
PMDs to manage osteomyelitis conservatively. Therefore, we Advances in Wound Care, 1(1), 44–47. https://doi.org/10.1089/wound.2011.0285
expected it to be appropriate for MRSA ulcers as well. 5. Benskin, L. L. (2016). Polymeric Membrane Dressings for Topical Wound Management of Patients With Infected Wounds in a
Challenging Environment: A Protocol With 3 Case Examples. Ostomy/Wound Management, 62(6), 42–50.
Ferris Mfg. Corp. provided the initial dressings for each of the example patients. As a result of her extensive experience using PMDs on well over one thousand patients, https://www.researchgate.net/publication/304629707_Polymeric_Membrane_Dressings_for_Topical_Wound_Management_of_Patients_
the author became so passionate about the benefits of these unique dressings that she is currently an employee of Ferris Mfg. Corp., makers of a prominent PMD. With_Infected_Wounds_in_a_Challenging_Environment_A_Protocol_With_3_Case_Examples