Healthcare Professionals
Case Study 1: Nonhealing Surgical Incision
OverviewA 78-year-old female was recovering from an extended right hemicolectomy for treatment of colorectal cancer when one of her incisions would not heal. While one of her two incisions healed normally, the second abdominal midline incision had developed a sloughy base and moderate exudates. Concerned staff nurses called in the wound-care nurse to review the wound.
The patient’s abdominal midline incision developed a sloughy base and moderate exudates.
- Staff nurses covered the incision site with a hydrofiber dressing containing ionic silver to control microbial activity, and dressing changes were made every other day
- Concerned staff nurses called in the wound-care nurse to review the patient’s wound
- The wound nurse recommended switching to a dressing with higher absorbance capacity and a higher concentration of silver and advised continuation of dressing changes
- Staff nurses followed wound-care nurse’s treatment plan
The wound edges were somewhat contracted, but excessive exudates and bleeding indicated that the wound was not healing normally.
- While edges of the incision wound appeared to be contracting, the wound was still sloughy; the wound bed was not filling with granulation tissue and there was evidence of bleeding
- Staff nurses called for another wound-team review
- The wound-care nurse noted excessive, foul-smelling exudates and recommended using an alginate gel to help manage the fluid
- Nurses continued treatment and consulted a surgeon
- Surgeon advised the nursing staff to give the patient 2 packets of Juven daily
After just 2 weeks on Juven, the wound edges had contracted, exudates were lessened, and the incision size was considerably reduced.
- Staff nurses and the wound-care nurse noted significant change in the wound
- The patient was discharged from the hospital and continued to take Juven twice daily at home
Case Study 2: Diabetic Foot Ulcer with Osteomyelitis
OverviewA 62-year-old male had a 20-year history of diabetes mellitus when he developed a diabetic foot ulcer with osteomyelitis. The patient sought medical attention after a crack on the bottom of his foot developed into a lesion. The tissue around the lesion was inflamed and necrotic. Four weeks later, a wound-care team administered a debriding treatment. The ulcer worsened and the patient developed osteomyelitis. The patient was treated with IV antibiotics for the next 9 months.
Wound-care team decided that the ulcer required a second debridement. After the procedure, wound measured 6.35 cm (L) x 5.08 cm (W) x 2.54 cm (H).
- Physician directed patient to clean the wound, change the dressing daily, and take an oral antibiotic (levofloxacin)
- In spite of the debridement, good home care, and adequate nutrition, the wound continued to worsen
- Consulting physician recommended below-the-knee amputation and wound-care team recommended hyperbaric oxygen therapy
Faced with potential amputation and hyperbaric oxygen therapy, the physician suggested that the patient add 2 packets of Juven to his daily diet.
- Patient mixed 1 packet of Juven with 8-10 fl oz of water, twice a day
- After 2 weeks, patient noticed his wound beginning to heal
- Patient continued to take Juven every morning and night for 6 weeks
Wound had reached remodeling phase.
- Patient returned to the wound care center for a follow-up visit
- Ulcer surface had diminished to 3.81 cm (L) x 1.27 cm (W)
*In healthy elderly adults.
References: 1. Williams JZ, et al. Ann Surg. 2002;236(3):369-375.
Use Juven as part of a complete, balanced diet.
