The wound that nearly got away: a case presentation.

Chronic cavity wounds are not commonly seen in pediatrics, and little literature is available on their management. A pediatric patient with juvenile dermatomyositis (JDMS) who had a chronic cavity surgical wound with an enterocutaneous fistula presented a nursing challenge. The patient had complex medical and surgical problems that greatly influenced her ability to heal. Nursing management of the wounds had to be innovative and flexible to adapt to these challenges. Factors affecting the patient's wound healing included JDMS; decreased mobility; persistently low serum magnesium, zinc and albumin; malnutrition; infection; and prolonged glucocorticosteroid therapy. Nursing management of her complex wounds included the following strategies: absorption of excessive exudate, wound support, debridement, wound irrigation, wound bagging, healing by secondary intention, and control of hypergranulation.

Juvenile dermatomyositis: a Roy nursing perspective.

With current medical treatment, juvenile dermatomyositis (JDMS) is rarely fatal. However, for most families, it is a chronic illness that interrupts life for both the affected child and the rest of the family. This article provides an overview of the disease, presents a case history of a 9-year-old affected girl, and discusses nursing care using the Roy Adaptation Model and nursing diagnoses.