Patient data and anamnesis:

36 year old female patient with tissue destruction on both lower legs. The cause is the injection of heroin. There is a stage 2 PAOD.

Author: Daniela Laskowski, nurse, wound expert from Fulda

Change of dressing on 03.08.2015:

During the first dressing change, the wound was still contaminated and strongly reddened. Cleaning with LIGASANO® wound cleaning sponges intensive was painless and very effective. The wound cavities and the underminations were each padded with a LIGASANO® white wound band mini up to the wound edge and covered with a layer of LIGASANO® white sterile 10 x 10 x 1 cm. Fixation with breathable adhesive fixation fleece. Additional positioning of the patient on one layer each of non-sterile LIGASANO® green and LIGASANO® white. Bandage change 3 times a week.

Conclusion on 16.09.2016:

Wound completely healed. Patient sweats very heavily (due to various medications), which leads to maceration and new skin defects. Therefore, LIGASANO® white wound strip mini will continue to be applied prophylactically.

Author: Helga Huber, Medical Assistant, VERAH, Lower Bavaria

Patient data and anamnesis:

81-year-old mobile patient, condition after falling on the left knee and lower leg with subsequent pronounced hematoma. After approx. two weeks in the distal lateral lower leg area swelling and rough tissue resistance to approx. 15 x 10 cm.

The patient was presented surgically after the trauma. Therapy arrangement: hepathrombo ointment dressing. In the further course a dry necrosis in this area was demarcated and later a moist necrosis. Surgical presentation outpatient on 22.02.2017 for debridement.

Secondary findings: CVI stage 1 according to Widmer; condition after osteosynthesis in fracture of the OSG several years ago. Thus also edema inclination and slight movement restriction of the OSG.

On 25.02.2017 the wound size was 2.5 x 3 x 1.5 cm, tibial undermining 1.5 cm, dorsal undermining 1.8 cm. After dorsal spongy necrotic tissue/coagulum, after tibial appears firmer structure, exudate moderate, bloody, no wound odour. Wound environment livid, under slight compression edema well receding.

Wound therapy: Wound cleaning with LIGASANO® wound cleaning sponge interdigital medium in combination with Prontosan W

Wound filler: LIGASANO® white Tamponade (Wound strip micro); Wound dressing: LIGASANO® white sterile compress 10 x 10 x 1 cm

Fixation: Tubifast and short-stretch bandage with light compression. Bandage change once a day.

The bandage is also left at night and well tolerated. Patients hardly reported any pain, short-term pulling during wound cleaning.

On 05.03.2017 the wound size was 2.5 x 3.5 x 1.5 cm, tibial undermining 3 cm, dorsal undermining 3 cm. As far as visible necrotic tissue/coagulum repelled, wound bed moderately fibrinous, after tibial significant increase of fistula. Exudate moderate, less bloody, no wound odour. Wound environment livid without signs of infection, therapy recommended further with LIGASANO® white Wound strip/tamponade and secondary as wound dressing, for the wound bed Repitel Wound gel.

On 23.03.2017 the wound size was 2.5 x 3.5 x 1.5 cm, tibial undermining 2.5 cm, dorsal undermining 2 cm. As far as visible wound bed without coatings with good granulation and epithelisation tendency, not completely visible after tibial. Exudate moderate, discreetly bloody, no wound odour, wound environment intact, moderate oedema.

On 29.03.2017 the wound size was 2.0 x 3.0 cm x 1.3 cm, undermining tibial 2.5 cm, dorsal 1.5 cm, exudate moderate, discreetly bloody, no wound odour, wound environment intact, moderate oedema, daily dressing change. At first nothing was changed in the dressing regime. From 05.04.2017, the wound filler was to be replaced by an alginate tamponade (surgeon insisted on the use of alginate) and LIGASANO® white sterile compress as wound dressing. The dressing continued to be changed daily.

On 14.04.2017 very abundant bloody exudate was repeated, the wound environment appears irritated, reddened and slightly inflammatory. Sorbalgon was discontinued for testing.

On 18.04.2017 the wound size was only 1.5 x 2.8 x 0.3 cm, significant improvement under Repithel Gel and LIGASANO® white; wound edge protection with Dline Zinc Cream. Exudate moderate, no longer bloody, no wound odour, wound environment less irritated, significant reduction of wound area and good granulation and epithelialisation.

From 03.05.2017 the secondary dressing was changed to Mepilex postop.

The dressing change interval was adjusted in the course of wound therapy up to three times a week. During the therapy, a two-part stocking system of compression class 2 was used in order to reduce oedema and provide the patient with the greatest possible mobility.

Conclusion: The use of LIGASANO® orange (wound cleaning sponge medium) was able to achieve rapid wound cleaning and thus shorten the therapy time. LIGASANO® white as a wound dressing has proven to be very effective in this wound care and, thanks to its good drainage effect, has largely prevented damage (maceration) to the wound environment.

Author: Petra Hofmann, Nurse and AZWM® Certified Wound Manager, Rechenberg Bee Mill