47-year-old 5'10” woman with debilitating rheumatoid arthritis and peripheral vascular disease suffered from infected venous wound of left leg for over a year. Wound: 1.4cm longx1.0 cm widex0.4cm deep with 0.2 cm undermining under entire circumference. Partially exposed tendon at base, draining large amounts purulent yellow exudate. Antibiotic ointment, enzymatic debrider and wet-to-dry dressings all failed. Wound 100% fibrin/slough. On prednisone, methotrexate, cilostazol, lansoprazole. ABI's R: 0.68, L: 0.78. Pain: constant 5 on 0–10 scale.

Polymeric membrane dressings provide significant wound pain relief, presumably by inhibiting nociceptor activity at site. The ingredients draw and concentrate healing substances from body into wound bed to promote healing while facilitating autolytic debridement by loosening bonds between slough and wound bed. These unique dressings are able to add moisture to dry wounds while absorbing excess wound fluid, so they are recommended for dry wounds including exposed tendons as well as for heavily exudating wounds. Due to patient's need for steroids and co-morbidities, continued infection was concern. Silver polymeric membrane dressings have been tested and found to be bactericidal. Therefore, silver polymeric membrane dressings initiated. Compression contraindicated due arterial insufficiency.

Wound dressed with silver polymeric membrane wound dressings until cellulitis resolved, then plain polymeric membrane dressings. Changed 2–3 times/week, sometimes by patient.

Undermining healed by nine days, then slough began clearing and granulation began. Pain became intermittent at 2 – 3 instead of constant at 5. At 7 weeks, wound almost closed: 0.2cmx0.2cm. Tendon completely covered.

Use of polymeric membrane wound dressings resulted in pain reduction, cleaner wound bed and steady healing, despite steroid intake and arterial insufficiency. Wound almost fully closed (7 weeks - case ongoing). Cost-savings was significant with fewer weekly dressing changes, some of which are done by patient.