51-year-old female long-term-care resident fell → large hematoma to right lateral shin. PMH: diabetes, chronic anemia, psoriasis with topical steroid use, hypothyroidism, and infected pin sites. Fell again, breaking open hematoma into 13.0cmx5.0cmx0.1cm full-thickness skin tear. Steri-strips applied, ER unable to suture wound, gave her antibiotic ointment and non-adherent dressing to be changed twice daily. Seen by wound team the next day.

Polymeric membrane dressings proven to provide significant wound pain relief, presumably by inhibiting nociceptor activity at site. Contain a gentle cleanser, so no manual wound cleansing usually needed, allowing for less disruption of new growth at wound bed and very quick, easy dressing changes. Silver polymeric membrane dressings are also antimicrobial. Therefore, silver polymeric membrane dressings initiated.

Dried blood cleansed from wound gently with sterile water. Initially periwound area swollen with induration and wound drained moderate amount purulent light yellow exudate, so silver polymeric membrane dressings applied to prevent infection. Changed daily x2 weeks. Then wound consistently clean, so plain polymeric membrane dressings were changed every-other day, then every three days and finally every 5 days. Polymeric membrane dressings continued to complete wound closure. Wound cleansed only during first two weeks when it bled often, not throughout treatment as it would have been with other dressings.

Patient had absolutely no wound pain after first day, despite depth of wound. Wound bed cleaned up and began granulating quickly, with complete healing in three months.

Polymeric membrane dressings were easy to apply and effective. After initial cleansing and dressing by wound team, wound remained completely pain-free. Wound cleaned up quickly and healed in only three months, much faster than expected when using other dressings.