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A 53 year old woman, nil significant medical history presented with a Venous leg ulceration on the anterior aspect of her right leg. Duration two months - has been letting it 'dry' out however concerned that it is not getting better.

Trialled primary - intrasite gel, secondary - alleveyn non-adhesive, which resulted in extremely painful, stinging sensation which lasted until the next dressing change. As the area was extremely erythamatous and increased exudate Iodosorb was used.

Initially tolerated but patient reported after a few hours the stinging, painful sensation again. :bash:

Referral to District nursing for compression has been initiated as ABI: R - 1.07.

I was wondering if anyone had any ideas for a primary dressing that would be less painful and traumatic for the patient and encourage wound healing.

Any ideas/advice would be apprecited.:confused:

 

From my experience dealing with venous ulcers, you may want to stop using intrasite gel dressing. Venous ulcers are typically quite shallow and often presented with minimal/no slough.
I get good resolution using four layer compression bandage along with silver based dressings ( try Acticoat/Biatain Silver).
These dressings are to be changed weekly max.
In addition, the bandage are to be done with a pressure of 40mmHg. If you are unsure about doing it, you may want to speak to a wound nurse specialist.

 

Try an unna boot also.That would milk out some swelling there.

 

This has just been published:
The Symptom of Pain with Pressure Ulcers: A Review of the Literature
Kerrie Girouard; Margaret B. Harrison; and Elizabeth VanDenKerkof
Ostomy Wound Management

Full article