Venous ulcus cruris

The venous leg ulcer is typically a very heavily weeping wound. The main problem is to absorb large amounts of exudate and channel it so that it does not overflow to the wound edges. 

The heavily weeping wound is filled with LIGASANO® white and also covered with LIGASANO® white, overlapping the wound edges by at least 2 cm. If the change is made in good time, the overflow of the wound edges is counteracted. Excess exudate is absorbed. It may be advisable to use additional superabsorbents. 

The accompanying treatment (compression bandage, compression stocking) is carried out as usual. 

Arterial ulcus cruris

Consequences of arterial circulatory disorders usually begin below the knee. If there is no arterial occlusion, the LIGASANO® bandage can provide valuable services. 

The leg or foot lesion is locally treated with LIGASANO® white. The circulation-promoting effect is produced by the LIGASANO® bandage (300x10x0.3 cm). 

The LIGASANO® bandage is applied in 5 or 10 cm width like a normal padded bandage. They achieve both padding and stimulation of blood circulation at the same time. The LIGASANO® bandage does not tend to slip, but can be fixed with a mesh tube or better with LIGAMED® Fix if required. 

Ulcus cruris mixtum

The arterial venous leg ulcer is particularly difficult to treat because on the one hand the necessary blood inflow is missing and on the other hand it is hindered by compression measures due to the lack of outflow. 

The wound, which usually weeps, is filled with LIGASANO® white and also with LIGASANO® white. The wound edges are covered with at least 2 cm of overlap. If the change is made in good time, the overflow of the wound edges is counteracted. 

The LIGASANO® bandage is applied 5 or 10 cm wide like a normal padded bandage under the compression bandage or stocking. They achieve cushioning and blood circulation at the same time. 

57 years, female, with venous insufficiency, ulcus cruris and extensive lipodermatosclerosis. 

Excerpt from a post-marketing surveillance of the accident hospital Targu-Mureş, Romania.
To read the complete field report please click here

 

45 years, female, with very large and old venous ulcer cruris. Treatment is not yet completed.

Excerpt from a post-marketing surveillance of the accident hospital Targu-Mureş, Romania.
To read the complete field report please click here

 

Patient data and anamnesis:

71-year-old patient, diabetic type II since 2013, insulin-dependent since 12/2014, diabetic neuropathy, apoplexy 2014, hemiparesis right, dependent on wheelchair; very good domestic situation; cared by the wife; she also connects the wound.

Wound description:

Ulcus over the right Achilles heel since 10/2015, probably pushed at the wheelchair. Therapy from 10/2015 - 30.03.2016: Until 11/2015: hydrogel; fatty gauze (Lomatüll), 12/2015: started with medical honey, 12/2015: started with Silvercell, 01/2016: again hydrogel from Hartmann, 02/2016: further with Silvercell (granulation at the wound edge), beginning of 03/2016: change to foam with adhesive edge (Aquacel Foam) Wound condition on 06. September, 2010: the wound was in a state of flux.04.2016: Wound fissured, inflamed, with fibrin coatings, partial granulation; little wound odour; wound surface: approx. 12 cm long, 5 cm wide, 0.5 cm deep, skin in wound area dry and scaly, hardly any pain, but sensitive to touch.

The patient today has an appointment in the practice of Dr. Jecht, conversion to LIGASANO®, ulcer has remained unchanged with previous treatment; wound size and signs of inflammation have rather increased. Wound cleansing with Prontosan wound irrigation solution, wound base Prontosan wound gel X, dressing material: LIGASANO® white sterile stick 6 x 2.5 x 0.4 cm, LIGASANO® white sterile wound dressing 10 x 10 x 1 cm, LIGASANO® white non-sterile bandage 300 x 10 x 0.3 cm.

Authors: Astrid Kliem, nurse, wound expert ICW, Berlin, Dr. med. Michael Hecht, Havelhöhe Hospital, Berlin and Susanne Hagen, specialist nurse, wound expert ICW

 

Patient data, anamnesis + case description: 

76 years old, male, with arterial-venous mixed ulcer on both lower legs. Peripheral arterial occlusive disease grade IV in combination with chronic venous insufficiency (CEAP classification: C6 / Ep / A18 / PR+O). 

Healing of the primary ulcer in July 2016, patient's return in October with relapses in both legs. Various ulcerations with incipient peripheral edema. On a numerical pain scale from 1 to 10 the patient indicates 7. In order to exclude an acute vascular occlusion, the patient is again presented on an outpatient basis in vascular surgery and to clarify the possibility of compression of the lower legs. 

There is no acute arterial occlusion, the patient's ABI is 0.75; controlled compression with 30 mmHg is approved. The Medi system (circaid juxtacures) is adapted for both lower legs after consultation with the family doctor in order to ensure a safe possibility for care in the patient's home. 

The local wound treatment is coordinated with the family doctor as follows: 

•     Wound cleaning with Prontosan rinsing solution and LIGASANO® wound cleaning sponge medium (orange) 
•     Wound dressing LIGASANO® white sterile 10 x 10 cm in the thickness of 1cm 
•     Since the patient is intolerant to adhesive fixations and the risk of constriction is increased by the current edema, the use of conventional fixation bandages, the LIGASANO® bandages were chosen for fixation and friction protection. This also supported the even application pressure of the circaid juxta cures. 
•     The dressing change interval was set to three times a week. 

In addition, the patient received an infusion therapy with Prostavasin, the topical treatment was continued during the hospital stay. 

After 6 weeks the healing was complete and the compression therapy was continued. 

Mr. G. presents himself at regular intervals as an outpatient in vascular surgery. 

 

Authors: Karin Schaten, Nurse, Wound Expert ICW & Michael Barak, Nurse, Wound Assistant DGfW