Three Years Experience of Treating 46 Painful Diabetic Foot Ulcers with Polymeric Membrane Dressings
Problem: Early recognition and proper wound care are crucial to a good outcome for diabetic foot ulcers. Otherwise, foot ulcers may lead to serious infection, gangrene and lower extremity amputation.
Patients with diabetic foot disease and ulcers also often suffer from wound pain, an issue which has not been given a lot of significance in the practice arena. Based on our clinical observations, we came to the conclusion that we need to use a dressing that preserves the integrity of the ageing skin, is atraumatic, reduces pain, controls exudate, prevents infection, and is suitable to the local clinical conditions of the diabetic foot. The purpose of this study is to present our findings utilizing a dressing that promotes healing of the diabetic foot ulcers while providing the other benefits required.
Methods: We treated 46 patients, since 2009, with painful diabetic foot ulcers with a mean age of 83. We applied polymeric membrane dressings (PMDs), with and without silver to promote wound healing. Exudate levels determined which type of PMD was applied. For wounds that had some depth, PMD cavity fillers were applied. For wounds that were dry, PMDs were first moistened with a few drops of normal saline.
Results: Almost all patients were successfully treated. Unfortunately, 2 patients died due to other complications but their foot ulcers were nearly healed. For all patients, within weeks pain levels dropped from an average of 8 (0-10 scale) to pain-free. Some patients completely discontinued the use of analgesia for pain associated with their wounds. The average healing time was 4-6 months and we saw no infections during this period.
Conclusions: PMDs helped us achieve our goals of improving outcomes. As a single treatment modality it is effective for all phases of wound healing and does not require additional treatments or additives.
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