A moderately protein-malnourished tailor in rural northern Ghana developed two venous-hypertension ulcers (largest: 5.75cmx4.5cmx0.2cm deep) on dorsum of L foot several weeks prior to coming to clinic. Patient's employment of treadle-powered sewing machine made elevation of foot and use of available compression-bandages impractical. After initial sharp debridement, a variety of wound dressings were attempted. Wounds increased slightly in size due to maceration and remained avascular during this time.

After two months, polymeric membrane dressings became available. Polymeric membrane dressings have demonstrated ability to inhibit infection while keeping wounds appropriately moist, and wounds treated with them quickly formed granulation tissue in this setting. When these dressings were initiated, skin surrounding wounds was extremely macerated. Zinc oxide was applied. Extra-thick polymeric membrane dressings were applied directly to the heavily exudating wounds. Clear drainage from wounds was contained by these dressings, allowing two days between clinic visits without maceration. Treatment also included extensive nutritional teaching and prayer.

Granulation tissue formed quickly along wound edges and wound bed moisture became appropriate with maceration completely healed in two weeks. Patient developed a purulent wound infection when he got malaria, but this resolved after three dressing changes with saline washes to the wound-bed. After this, wound-bed cleansing was required only intermittently. Nutrition remained a problem throughout treatment; tailor often could not afford peanuts or beans. Wounds were almost completely healed (1.1cmx1.3cm and 0.5cmx1.0cm, both fully granulating) after three months, but then patient began getting dressings wet while bathing, leading to maceration and several new wounds in scarred area. Ramadan fasting and malaria also depleted his body's resources during this time. Wounds finally completely closed five months after initiation of polymeric membrane dressings.

Polymeric membrane extra-thick dressings provided effective wound management for these venous ulcers even without the benefit of compression therapy.