PROBLEM A 58-year-old male bariatric (BMI 55) department store worker frequently misses work due to three left lower leg venous hypertension ulcers which were treated with oral antibiotics and twice-daily silver sulfadiazine or a compression boot without improvement. Referred to wound care nurse after 7 months. Patient had lower leg hyperpigmentation, dilated veins. Periwound skin edematous and slightly macerated. Largest ulcer 4.0cmx3.0cmx0.5cm deep, draining significant quantities of light yellow fluid. Naproxen sodium for pain: 5 during dressing changes, 3 at other times on 0–10 scale.

RATIONALE Polymeric membrane dressings are proven to provide significant wound pain relief, presumably by inhibiting nociceptor activity at the wound site. The integral components create an ideal moist environment which concentrates the body's natural healing nutrients by absorbing the watery portion of wound fluid. Dressings contain both foam and super-absorbent starch, so they are recommended for heavily exudating wounds. Silver has additional anti-infective properties. Therefore, silver polymeric membrane dressings initiated.

METHODOLOGY Patient placed on oral antibiotic for two weeks based upon culture results. After thorough cleansing with saline, silver polymeric membrane dressing applied with compression boot over it. Initially skin barrier spray used on periwound skin due to maceration, but no longer needed after polymeric membrane dressing use established. Wound areas are being cleansed with normal saline at each dressing change due to large quantity of exudate. Silver polymeric membrane dressing and compression boot to be changed twice/week.

RESULTS Study is ongoing. Patient no longer has wound pain. Two smaller ulcers completely closed, largest only 1.5cm x 1.2cm x 0.1cm after 6½ weeks' treatment with silver polymeric membrane dressings.

*PolyMem^® Silver^TM Wound Dressings, Burr Ridge, IL 60527