A case study demonstrating the use of appropriate dressings to promote patient wellbeing

Abstract

Patients with chronic mixed aetiology leg ulceration can prove challenging particularly when repeated episodes of infection occur. It is therefore important that an appropriate dressing is selected to manage wound bioburden (Wounds UK, 2011). Mr B is a 93 year old gentleman whose mobility is declining. He has had his leg ulcer for over seven years and visits the tissue viability centre weekly, accompanied by his daughter. His past medical history includes essential hypertension, chronic kidney disease and senile macular degeneration. Mr B had previously been treated with multilayer compression bandaging which applied 40mm Hg at the ankle to reverse venous hypertension. Initially he was seen in clinic twice weekly, however due to decreased mobility, his general poor health and his daughter’s work commitments, attending twice weekly proved difficult for them. Following discussion with Mr B and his daughter we decided to teach his daughter how to dress her father’s limb so he could reduce his visits to the tissue viability centre. In order to achieve this, maintain a therapeutic level of compression and to manage the wound, two made to measure liners (JOBST^® UlcerCARE, BSN medical) which each apply 15mm Hg at the ankle were prescribed. This would allow for self-management as he could remove one liner at night and replace it in the morning.