69-year-old female presented with pneumonia and small pruritic warm draining open areas on both ankles; treating with steroid ointment. Began silver sulfadiazine covered with 4x4's. Worse after a month: severe itching, pain, right lower leg cellulitis. Hospitalized: daily whirlpool, silver polymeric membrane wound filler to open areas, absorbent stretch gauze, 2 layers compression stocking. History: venous dermatitis ulcerations, hypertension, arthritis, COPD, varicose vein ligation, recent bilateral knee surgery. After ten days, Unna's Boot applied by physician, dismissed to WOC Nurse out-patient.

Polymeric membrane wound filler wicks exudate directly away from wound surface, preventing maceration. Excess fluid wicks through filler into compression dressing. Filler contains glycerin to soothe and hydrate wound while drawing and concentrating healing substances from body into wound bed, plus surfactant to continually cleanse wound. No additional cleansing needed. Filler plus compression seemed ideal for patient.

Leg cleansed. Polymeric membrane wound filler plus four-layer compression wrap applied. Changed ~weekly. No routine wound cleansing. 6 weeks: remaining wounds small, scant exudate. Covered with plain polymeric membrane dressings; 20-30mmHg stockings. 10 weeks: new ulcers formed, MRSA+. Oral antibiotics initiated. Filler covered with compression wrap resumed. 13 weeks: Almost complete healed, then hospitalized: IV antibiotic for MRSA to hand (injured scratching dressing), R lower leg. Changed to silver polymeric membrane wound filler, compression. Filler covered with wrap continued fifteen days until complete closure. Dismissed: oral antibiotics 3/week for 3 months, conditioning cream, thigh-high 20-30mHg stockings.

Wound filler plus compression successful in closing venous dermatitis induced wounds in 3 – 6 weeks, but MRSA infection relapses greatly prolonged overall recovery time. Eight weeks post-dismissal skin remained intact without rash. Pruritis significantly diminished.

Unique treatment, polymeric membrane wound filler under four-layer compression wrap, consistently resulted in healing. Antibiotics and continuing filler plus compression to complete healing resulted in permanent closure.