Case Study: Post-operative wound on a broken ankle

A 55 year old broke her right ankle in three places. The ankle was repositioned on the same day and several plates and screws were put in the ankle the next day. Although she was a heavy smoker and on antidepressant medication, her general health was in a reasonable condition. 

After being discharged from the hospital, the post-operative wounds were only covered with a gauze. The lateral wounds were inflammatory and the decubitus wound in the ankle was necrotic. The doctor decided to treat the wound with L-Mesitran ointment, because of previous successful experience in similar wounds. In this case, the expectation was that the Ointment would debride the necrotic wound and help in controlling the infection.

The patient’s family was instructed to apply the Ointment daily, covering it with a gauze  and fixing it with a bandage.The doctor regularly inspected the progress of the wound. It was obvious that the wound was infected. It was red and warm in the periwound area but had no malodour. After one week of treatment, the necrotic tissue was under control.

In the first week, the patient used paracetamol for the pain caused by the fracture and surgery. However, the dressing changes were painless. The gauzes did not adhere to the wounds, because of the honey-based ointment.

The wound initially became larger, but after the manual debridement, the wound size rapidly declined. Granulation and epithelialization occurred rapidly. After 47days of daily treatment, the wound completely healed. It is striking that the lateral wounds barely had any scar formation.  

 The wound infection was successfully treated without antibiotics. This is an important result given the rise in antibiotic resistance. In just 47 days, the wounds epithelialized and healed completely with almost no scarring.The wounds were treated by the patient’s family after simple instructions by the doctor.