A 68 year-old patient is being seen for the first time for a left leg wound. Patient states the wound appeared about five weeks ago

A 68 year-old patient is being seen for the first time for a left leg wound. Patient states the wound appeared about five weeks ago. The wound was small and he was covering it daily with a pad dressing thinking it was going to heal. He has a history of venous insufficiency and does not smoke. Today, the wound measures 12cm x 7.2cm and the wound has a slimy appearance, mostly covered with slough/necrotic tissue with areas of red friable tissue. The leg is swollen and there are areas of skin breakdown to peri-wound with redness. There is a large amount of seropurulent drainage and foul odor. Patient states pain has increased. He denies fever and chills. Patient’s oral temperature today is 98.2F. Answer the following questions: 1. Identify the stage of bacteria load on the wound. 2. Describe how you came to this decision. 3. What topical antimicrobial agent would you apply to this case? 4. How would you prevent further wound healing implications?

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