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Case Study
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Benefits of biocellulose dressing with traditional compression therapy on chronic venous insufficiency wounds Kimberly Miner, ND, CNS, CWCN, FAPWCA, Wound Care Associates, Englewood, CO Objectives: Development of protocol using biocellulose dressings with traditional compression therapy on chronic venous insufficiency wounds. Evaluate efficacy, cost-effectiveness and pain reduction of protocol Biocellulose dressings provide exudate absorption, tissue hydration, autolytic debridement, decreased trauma, pain reduction and improved granulation. Three case studies presented Protocol included weekly wound cleansing of wound, application of periwound emollient, biocellulose dressing, and two layer bandage providing 20Ð30 mmHg. Prior to implementation of protocol, patients were seen daily to 3x/week Case 1: 83-year-old man with history of venous insufficiency and RLE wounds x 4, HTN, and cellulitis . Previous treatments included anodyne therapy, enzymatic debriding, silicon dressings, silver nitrate cautery, silver alginate, compression therapy. No consistent improvement in wound and significant periwound tissue deterioration with previous treatments. Wound 7 months-old at start of protocol. Wounds 0.3x1.5xeschar, 1.2x0.5xdusky, 0.7x0.6x0.15, and 1.0x0.8x0.15 at 11/11/05. Wounds debrided and protocol started. At 12/6/05, wound 1 measured 0.1x0.2x0.01, wounds 2 and 3 were healed, and wound 4 measured 1.0x0.9x0.1 Case 2: 72-year-old woman with history of venous insufficiency and LLE wound, mental retardation, HTN, pruritis. Wounds approximately 10-years-old at admission. Previous treatments included Unna boots, TAO and DSD. Wound measured 4.0x5.5x0.1 at 11/22/05. Wound mechanically debrided and protocol started. At 12/6/05 wound was 2.9x4.9x0.1, 35% reduction in volume Case 3: 80-year-old woman with DJD and history of recalcitrant wound to R lateral ankle. Previous treatments included topical silver, compression, enzymatic debrider, anodyne therapy, antimicrobial dressings and bioengineered tissue grafts. Wound 0.7x0.2x0.1 at 11/18/05. Protocol started. At 12/2/05, wound 0.2x0.2x0.01, 97% reduction in volume. Conclusion: Use of biocellulose dressing decreased visits to 1x/week, significantly reducing costs. Patients reported decreased pain or pruritis, and periwound skin showed improvement. Protocol resulted in significant reduction in volume in chronic venous insufficiency wounds. Aung BJ. Does a new cellulose dressing have potential in chronic wounds? Podiatry Today. 2004;17(3):20Ð26 Alvarez OM, Patel M, Booker J, Markowitz L. Effectiveness of a biocellulose wound dressing for the treatment of chronic venous leg ulcers: results of a single center randomized study involving 24 patients. WOUNDS. 2004;16(7):224Ð233. |
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