Clinical Case Study - Surgical Wound - Granudacyn® & Avance® Solo

Clinical Challenge

To aid integration and revascularisation of a dermal replacement scaffold plate and split thickness skin graft following the excision of a recurrent skin cancer.

Patient and Wound History

• 83-year-old male.
• Medical history of hypertension, chronic lymphocytic leukaemia, chronic kidney disease.
• Excision of 3 malignant melanomas from the left shoulder; excised as 1 lesion (boomerang shape) with some undermining to allow for closure with 2-layer subcuticular sutures.

Intervention and Treatment Regime

• Granudacyn® Wound Irrigation Solution (intervention), a hypochlorous acid solution, was chosen to cleanse the wound and so reduce the risk of infection. Avance ® Solo (intervention), a portable single use negative pressure wound therapy (NPWT) system, was chosen to provide effective exudate management (wound drainage transferred to canister to prevent accumulation in wound) and support faster healing of a wound in a difficult to dress area.
• At excision of the cancerous lesion, the wound (6cm x 7cm) was cleansed with normal saline. During the surgical debridement procedure and at all dressing changes, the wound was cleansed with Granudacyn®
• After all procedures, Avance® Solo Border dressing (foam) was placed over the wound and the NPWT pump/canister connected. Fourteen days post excision, surgical debridement was performed to remove a haematoma (~20%) under the dermal replacement scaffold plate, after which treatment with Avance ® Solo was continued. Forty two days post excision, a split thickness skin graft was performed; Avance ® Solo was used until the wound had healed.
• Dressings were changed weekly.

Wound Progression

Clincian's Perspective

Avance ® Solo NPWT helped the dermal template to integrate and the skin graft to take without the need for a protective wound contact layer as the Avance ® Solo Border dressing with Safetec ® technology helped prevent dressing adherence. The patient was very pleased with Avance ® Solo as it allowed her to continue with her social activities.

Dr Ibby Younis Consultant Plastic Surgeon, University College Hospitals NHS Trust, London, UK

^{Acknowledgement: This case study report has been prepared by Mölnlycke’s Global Medical Affairs team and is distributed with permission of the responsible clinician.}