Concrete stone fell, crushed middle-aged woman in northern Ghana's R foot. Several weeks of treatment to wound with local herbal poultices failed to produce any healing or halt increasing infection. Arrived at clinic with avascular eschar- and slough-filled heavily-exudating 7.0 cm x 7.0 cm x 0.3 cm deep full-thickness wound, plus acute malaria. Pain constant, severe. Staying in village only six miles from clinic during treatment. Grafting not available in area.

Dressing needed to reduce pain and stay in place as she walked to and from the clinic. Quick healing critical because woman was living away from home during treatment. Clinician had previously observed immediate granulation tissue formation in wounds through use of polymeric membrane dressings. Flexible dressings reduce pain, aid in preventing infection, and donate moisture to dry wounds while absorbing excess drainage. Therefore, after debridement, extra-thick polymeric membrane dressings applied directly to wound, changed every-other-day. Later, wound-care frequency twice/week. Wound cleansing not necessary after first week. Treatment also included vitamin c supplements plus teaching on nutrition, chloroquine for malaria, prayer, initial IM antibiotic followed by oral antibiotics. Patient instructed to elevate right foot as much as possible.

Pain greatly reduced, wound infection resolved within a week. Wound moisture became appropriate, granulation tissue formed quickly. Wound healed, patient returned home in nine weeks.

Thick polymeric membrane dressings provided effective wound management for full-thickness crush wound from initiation of treatment to complete wound closure. Use of polymeric membrane dressings controlled pain and infection and completely eliminated necessity of wound cleansing.

* PolyMem^®Max^TM Wound Dressings, Ferris Mfg. Corp., Burr Ridge, IL 60527