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Case Study/Series
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Solving the closed wound edge problem in venous ulcers using polymeric membrane dressings* First Author: Linda Benskin Authors: Linda Benskin, BSN, RN, Ghana SRN, CWCN PROBLEM Venous hypertension ulcer patients frequently present with chronic non-healing wounds with closed rolled edges (epibole). Practice guidelines advocate use of silver nitrate or sharp debridement to remodel edges and allow healing. But, clinicians often not permitted to remove live tissue. Surgical consult costly and difficult logistically if patient is at home, in long-term-care or on anti-coagulants. RATIONALE Polymeric membrane dressings contain hydrophilic glycerol, which both moisturizes directly and draws moisture from body, and a surfactant which alters chemistry of adjacent tissues. Applying polymeric membrane dressings to wound so that dressing makes good contact with closed edges often results in edges opening up quickly, initiating renewed wound healing. Method is cost effective, reduces pain, and avoids bleeding and other complications associated with surgery. METHODOLOGY Polymeric membrane dressings applied with gauze roll in center to push dressing into contact, or wound filler applied with smaller piece of filler or dressing pushed into center of wound. RESULTS Wound edges flattened and granulation tissue quickly formed, migrating from edges to center of wound bed. Previously non-healing wounds healed without silver nitrate or surgical intervention. CONCLUSION Polymeric membrane dressings, when forced into contact with rolled wound edges, moistened those edges and stimulated new growth. |
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