Management of Traumatic Knee Abrasion in Young Adult Athlete

Case at a Glance

A 21-year-old female skateboarder presents with concerns about wound healing and possible infection of a knee abrasion sustained during a fall 3-4 days prior. The patient reports persistent drainage and adhesion of dressings despite initial wound care.

Patient's Story

The patient, an active skateboarder, sustained trauma during a fall several nights ago, resulting in a palm-sized abrasion on her knee and a smaller abrasion on her shoulder. While the shoulder wound is healing appropriately, she has experienced ongoing issues with the knee wound. Initial wound care included cleaning with hydrogen peroxide and wound wash, followed by bandaging. The patient noted painful removal of bandages due to adherence to the wound bed. She subsequently began applying topical antibiotic ointment (neosporin), which provided some improvement, but continues to observe wound drainage and bandage adherence.

Initial Assessment

Patient presents with a healing abrasion on the knee measuring approximately palm-sized. The wound demonstrates ongoing serous drainage with some adherence to dressing materials. Physical examination reveals a superficial abrasion without obvious signs of deep tissue infection. The wound bed appears to be granulating appropriately despite patient concerns.

The Diagnostic Journey

Clinical evaluation focused on differentiating between normal wound healing with expected drainage versus potential bacterial infection. Visual inspection of the wound and drainage pattern was performed. The wound appearance, drainage characteristics, and surrounding tissue were assessed for signs of infection including erythema, warmth, purulent discharge, and spreading cellulitis.

Final Diagnosis

Healing traumatic knee abrasion with normal wound drainage, no evidence of bacterial infection. The patient's symptoms are consistent with expected healing process of a superficial abrasion.

Treatment Plan

Continue current wound care regimen with modifications: 1) Daily cleansing with soap and water, 2) Application of thin layer of topical antibiotic ointment, 3) Coverage with non-adherent gauze dressing changed daily, 4) Pre-moistening of gauze with water before removal to minimize trauma and discomfort, 5) Patient education on normal healing process and signs of infection to monitor.

Outcome and Follow-up

Patient expressed satisfaction with the treatment recommendations and demonstrated understanding of proper wound care techniques. Advised to continue current regimen and seek medical attention if signs of infection develop, including increased redness, warmth, purulent discharge, red streaking, or systemic symptoms.