Dressing choice and its impact on pain management

This case study demonstrates the impact pain can have on a patient’s quality of life and how changing wound treatment effectively can have a positive effect on wound healing.

The patient presented with a previous history of a venous leg ulcer since 5th September 2022; her ankle brachial pressure index (ABPI) was within normal limits indicating venous disease . She had a past medical history of Ischemic heart disease, diabetes, and hypertension which could also impact healing. Her practice nurse was treating her wound before she attended her local Leg Ulcer Clinic. During the several months she attended the Leg Ulcer Clinic her ulcer remained static with no signs of healing. Pain levels had been high which was having an impact on dressing choice and her quality of life. She was often tearful when discussing her ulcer at dressing change, she was “feeling low and didn’t really want to do anything” and expressed fear the wound would never heal, and she would be living like this for the rest of her life.

Hydroclean^® Advance was applied as a primary dressing, with superabsorbent dressing for exudate management, wool bandage for shaping the leg, and a two-layer full compression bandage system Hydroclean^® Advance was started on Monday 12th June 2023, then reviewed in clinic on Thursday 15th June 2023. The wound showed great improvement, with 75% of slough removed. The patient expressed this was the first time her wound had been completely pain free, ‘she almost forgot it was there’. 1 week after starting the Hydroclean^® Advance the slough was completely debrided, and the patient still had no pain in her wound or leg. The patient was shocked with the results, she had never seen her ulcer without the slough, or it appear so healthy. Her wound continued to improve remaining painless, on 28th August it was almost healed and measuring width 1cm - length 1.5cm. Dressing changes are now weekly, and compression wraps introduced as bandages are no longer required. (photographs represent the wound pre and post treatment with HRWD)

This case study demonstrates how Hydroclean^® Advance has reduced the amount of pain experienced with a chronic wound. Understanding the key objectives for the patient was paramount in improving the impact on the patient's quality of life. The patient is now managing daily tasks and leaving the house to spend time with family and friends.

Emily Salmeron Tissue Viability Specialist Interest Nurse, Upper Lea Valley, Hertfordshire NHS Trust