Objectives: Determine efficacy of porcine xenagraft in hard to heal venous insufficiency ulcers.

Abstract: 85-year-old female with a 30-year history of venous insufficiency ulcers to bilateral lower extremities. Receiving treatment to LLE beginning December 2003. Treatment modalities previously attempted were silver sulfadiazine cream, papain-urea debriding ointment, papain-urea-chlorophyllin copper complex sodium ointment (PUC) , Unna boot, anodyne therapy and serial sharp debridement. Wounds showed minimal improvement with these treatments.

7/30/04: Patient first evaluated for xenagraft application. Wound debrided to 8.7x3.4x+0.1. Xenagraft 7x3cm was applied to proximal half, PUC applied to distal half to determine to which treatment the wound would respond. Entire site covered with cadexomer iodine pad with Unna boot and light compression.

8/4/04: Xenagraft applied to entire wound bed after evaluation of prior treatment. Entire site covered with cadexomer iodine pad with Unna boot and light compression. Wound measures 8.4x3.3x+0.2. Hypergranulation noted.

8/9/04: Wound now two distinct areas proximal 5.5x3.4x0.1, distal 2.5x3.2x+0.1. Small pieces of xenagraft were noted at wound margins and were left in place. Hypergranulating tissue was cauterized. Silver alginate dressing and non-calamine Unna boot applied weekly.

8/31/04: Proximal 0.3x0.6x+0.05, distal wound x2: 2.0x1.5x+0.01, 1.2x2.9x+0.2. Wound debrided and cauterized due to excessive bleeding. Tissue to the proximal wound is much less friable in nature. Xenagraft applied to all wounds. Site covered with non-adherent dressing and Unna boot with light compression. Weekly Unna boot thereafter.

9/28/04: All wounds healed with exception of small medial wound 0.8x0.5x0.05.

Conclusion: µ Porcine xenagraft with Unna boot enhances wound healing and facilitates epithelialization in venous insufficiency wounds. µ Use of xenagraft improved patient comfort and reduced painful dressing changes µ Home health visits reduced from daily to 1-2x/week, reducing costs significantly and maximizing the resources of the HHA.