Problem: Ulcers caused by reduced arterial perfusion are often covered with slough and/or necrotic tissue and are challenging to treat due to pain and the underlying etiology. For the past 5 years we have treated these types of ulcers with polymeric membrane dressings (PMDs) for their pain relieving effect and debriding properties. The purpose of this study is to present our clinical experience of debriding, treating and healing arterial ulcers in the home care setting.
Methods: 26 patients, between 65-95 years old, were managed. Initially assessed at the wound center, but treatment performed at home. PMDs, with and without silver, were applied. All patients and family were educated by the community nurses how to manage their wounds with PMDs. They were taught to change the dressings when they could observe that the wound fluid reached the wound margins (visible from on top of the dressing).
Results: Of the 26 patients, 4 passed away, 3 needed amputation, 3 were lost to follow-up and 5 dropped out due to cost of dressings. In the remaining 11 patients (including the 5 that needed a bypass) the pain level dropped to an “acceptable” level of 4 or under (0-10 scale), after 2 weeks treatment (initial level 10) and healing time ranged between 5 to 6 months. There was no significant difference in healing rate between those who had undergone bypass and those who didn’t.
Our patients are often too old or have too many concomitant diseases to be candidates for surgical intervention. Arterial ulcers cause considerable pain and decrease quality of life. By using a simple, effective treatment that the family members can perform we have, in most cases, been able to heal their wounds in an easy, cost-effective manner.