Super-absorbent Dressings and Two-layer Compression Wrap Use in the Management of Lower Extremity Wounds

Introduction: Up to 3/1000 people are estimated to have leg ulcers with prevalence increasing to 20/1000 for people >80 years old. 1 These lower extremity wounds are often chronic, highly exudative, and associ- ated with venous insufficiency. Management of these wounds involves advanced wound dressings designed to absorb large amounts of wound exudate and compression therapy. The use of advanced wound dressings, super-absorbent secondary dressings, and two-layer compression in 7 patients with lower extremity wounds is presented. Methods: Wounds were assessed and managed with advanced wound dressings (oxidized regenerated cellulose [ORC]/collagen/silver-ORC* or hydrofiber with silver dressings†) along with super-absorbent dressings‡ and two-layer compression wrap§. Dressing changes occurred 1-2 per week, depending on the level of exudate present. One patient received an advanced elastomeric skin protectant** prior to dressing and compres- sion application. Results: Seven patients presented for care (age range 41-88 years). Wound types included skin breakdown secondary to skin blistering from lymphedema (n=1), fluid overload ulcer (n=1), venous leg ulcers (VLUs, n=3), vasculitis (n=1), and traumatic ulcer (n=1). Previous medical history included VLU, lymphedema, obesity, diabetes, vascular insufficiency, and endovenous ablation. In all 4 patients, increased granulation tissue development along with reduction of wound area and exudate volume was observed after treatment for 14-28 days. Complete wound healing was noted in 4 patients within 46 days of presentation. Granulation tissue development and decreased slough were observed in the wound bed of the remaining patients. Hydrofiber with silver dressing and super-absor- bent dressing use was continued. Discussion: Use of advanced wound dressings, super-absorbent dress- ing, and two-layer compression wrap resulted in complete wound healing in 4 patients. This wound management plan contributed to increased granulation tissue development and reduced slough observed in the remaining patients.