Congress Abstracts 2005

97

MANAGING SKIN RELATED INFECTIONS IN CUTANEOUS T CELL LYMPHOMA PATIENTS WITH IONIC SILVER IMPREGNATED DRESSINGS. Karen Koch, RN, BSN, Rae Rapisardi, RN, Orranah Saxelby, RN, and Robin Gemmill, RN, MSN, City of Hope National Medical Center, Duarte, CA.

The survival rate for cutaneous T cell lymphoma (CTCL) continues to improve due to early detection and advanced therapies. Cutaneous infections however remain one of the primary causes of morbidity for these patients challenging the hematology nurse’s ability to effectively manage skin related symptoms while preventing infection and improving patient outcomes.

The purpose of this abstract is to outline a process implemented by the hematology nursing staff to treat and prevent secondary skin related infections for CTCL using topical ionic silver impregnated dressings.

Patients with advanced stage CTCL are often hospitalized because of secondary skin infections, related to ulcerations of skin patches, plaques and/or tumor. The hematology nursing staff consulted the advanced practice nurse (APN) familiar with the relevant evidence-based research and complex care needs required for the CTCL patient, to assist in the planning, treatment, and management of patients with active skin lesions. The APN suggested a topical antimicrobial agent; ionic silver impregnated dressing to reduce the risk for super infections related to immunocompromised condition and over usage of systemic antibiotics. The staff began using ionic silver impregnanted dressing as part of a comprehensive multidisciplinary program to address wound infection, excessive drainage, and pain management. Wound therapy with the ionic silver dressings, in conjunction with systemic antibiotics, surgical debridement, chemotherapy, and radiation therapy, demonstrated a decrease in wound infection and drainage. Pain management continued to be a challenge especially, as wounds began to heal. Morphine sulfate was compounded into the ionic silver gel placed into the wound prior to dressing changes resulting in reduced pain scores.

Integration of ionic silver dressings into the treatment plan changed the course of treatment by improving wound healing. Observing the beneficial outcomes of ionic silver dressings, the nurses began to identify and initiate preventative treatment reducing the costs of care with decreased frequency of dressing changes, decreased need for systemic antibiotics, and improved patient outcomes.

This unique approach to prevention and management of skin related infection enhances existing therapies and improves patient outcomes.