80-year-old diabetic woman with left lower leg ulcer from fall treated by surgeon with oral antibiotics, three-times-a-daily moist saline and long-stretch bandages for a month without improvement. Patient's lower leg edematous and hyperpigmented. Ulcer: 2.5cmx1.6cmx0.1cm deep, 50% slough, 50% granulation tissue, moderate amount serosanguineous drainage. Pain during dressing changes 5 on 0–10 scale. Smokes tobacco. Heavy caffeine user; able to care for herself.

Polymeric membrane dressings reduce wound pain and inhibit infection while donating or absorbing moisture as needed. Components draw and concentrate healing substances from body into wound bed to promote rapid healing while facilitating autolytic debridement directly by loosening bonds between slough and woundbed. Liquefied slough absorbed by dressing, often eliminating need for woundbed cleansing during dressing changes. Therefore, polymeric membrane dressings initiated.

Elevate leg. After thorough cleansing with saline, polymeric membrane dressing applied with compression stocking over it. Dressing changed by patient every-other-day until complete wound closure. No wound cleansing at dressing changes, per instructions for polymeric membrane dressings, but weekly normal saline cleansing done to remove crusts from periwound area.

Since no wound cleansing was done, complex decisions about disturbing new growth vs. removing dead tissue were eliminated and patient was able to change dressings. Polymeric membrane dressings quickly removed slough from woundbed, resulting in 100% granulation tissue by 9th day and complete closure (small scab) in only one month. Patient reported that she had no pain during dressing changes.

Wound healed completely in only six weeks, despite patient's advanced age, diabetes, and habitual use of vasoconstricting substances (nicotine and caffeine). Amazingly quick healing saved patient significant time and money. Patient also had complete freedom from pain through use of polymeric membrane dressings.