HEEL ULCER IN HOSPICE PATIENT CLOSED QUICKLY USING POLYMERIC MEMBRANE DRESSINGS*

RATIONALE This patient was so debilitated that her heel ulcer was not expected to close. Her foot was cold, with poor capillary refill and an absent pedal pulse. Dressings were needed to prevent any infection from becoming systemic and to contain the wound exudate. Bordered polymeric membrane dressings conform well to heels and have a semipermeable membrane to protect wounds from contamination. They contain glycerol, a surfactant, and a super-absorbent starch. Polymeric membrane dressings’ ingredients draw and concentrate natural healing substances from the body into the wound bed to promote rapid healing while facilitating autolytic debridement directly by loosening the bonds between the slough and the wound bed. The liquefied slough is absorbed by the dressing, often eliminating the need for potentially damaging and painful manual wound bed cleansing during dressing changes. Together the dressing’s components reduce wound pain by inhibiting nociceptor activity at the wound site. In the absence of sufficient nutrients from the bloodstream, the glycerol in polymeric membrane dressings can be utilized by the body as an energy source and a component of new cells. The decision was made to use only silver or standard polymeric membrane dressings, depending upon the condition of the wound bed.