CASE REPORTS   

Acta Vulnologica 2013 December;11(4):183-8

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English, Italian

Treatment of undermined wound edges: our experience

Gallarini A.

Vulnology and Surgery Casa di Cura “La Cittadella Sociale” Pieve Del Cairo, Pavia, Italy

The presence of undermined edges in a “difficult wound” of the lower limbs imposes a timely assessment of the issues related to the wound biology. The purpose of this presentation was to demonstrate that the use of appropriate methods and devices allows rapid prophylactic preparation of the wound bed, making it quickly suitable for surgical debridement. This case reports concerns a patient with diabetic foot, treated with oral hypoglycemic agents, post-traumatic wound with worsening complications and subsequent infection. Three dressings have been applied on alternate days, by placing a propyl-betaine and polyhexanide-based gel at the bottom of the wound, and a paste with alginate and silver ions on the undermining edges. The whole has been covered with greasy gauze. After the treatment, the lesion has undergone surgical debridement. The treatment with gel and silver ions paste allows the wound to reach the right moment for surgical debridement with very stable edges, not affected by the initial malacic appearance and previous undermining. The reduction in the inflammation halo on the surrounding skin is evident, and the wound bed is more suitable for direct removal. The preparation of the wound with a simple dressing, designed to minimize the characteristics of the acute lesion, makes the necrotic tissue more easily attackable, avoiding the sacrifice of recoverable vital elements.