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VLU Case Study: Bianchi, J

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The use of IntraSite Conformable dressing in the management of a sloughy venous leg ulcer

 

Introduction
The standard treatment for uncomplicated venous leg ulcers is graduated compression. When slough is present, however, healing can be delayed. This case history illustrates the care given to a patient with a sloughy venous leg ulcer.

 

The Patient
This patient was an elderly gentleman with an uncomplicated but difficult to heal venous leg ulcer (Fig 1.). The presence of slough was thought be partly responsible for the delayed healing. His ulcer was managed by the nurses in a leg ulcer clinic with Profore* multi-layer bandages.

 

The Challenge
To manage the sloughy tissue and reverse or control the venous insufficiency.

 

Aims

  • Remove slough
  • Prevent wound infection
  • Reduce exudate production
  • Enhance healing
  • Use a dressing which stayed in contact with the wound
  • To ensure that the surrounding skin did not become macerated.
  • The application of sustained, graduated compression to assist in reversing the venous insufficiency.

 

Intervention
IntraSite Conformable was cut to shape and then applied to the ulcer (Fig 2.) to facilitate autolysis of the sloughy tissue. Profore multi-layer bandages were applied to control venous insufficiency. The dressings were changed twice weekly.

 

Fig 1

 

Fig 2

 

Fig 3

 

Follow Up Care
IntraSite Conformable was discontinued once the sloughy tissue had been removed. The patient would continue to have multi-layer compression applied until complete healing had been achieved.

 

Outcome
Four weeks after commencing treatment there was a 50% reduction in sloughy tissue, the ulcer had reduced in size (from 32mm x 12mm to 23mm x 11mm), and new granulation tissue was present (Fig 3). After eight weeks the slough had been replaced by granulation tissue and fibrin. The ulcer at this time measured 22mm x 11mm.