Treatment for Stalled Venous Stasis Ulcer

Marta Ostler, PT, CWS, CLT, CCS, DAPWCA
St. Vincent Healthcare, Billings, MT

Patient Presentation

A 80-year-old male presented July, 11 2018 with a venous stasis ulcer sized 11 x 9 x 0.3cm. Ulcer had been present for 36 months. Comorbidities included:

  • Hypertension
  • CVA with mild left hemiparesis
  • Venous insufficiency/hypertension
  • Cardiac disease
  • CVI ulcer left LE x 7 years

Failed Therapy

  • Debridement
  • Compression therapies (Tubigrip®, short stretch wraps, 2-layer compression hose, and Velcro closure devices)
  • Vasopneumatic pump
  • Multiple CTP applications

Procedure & Treatment

  • Culture to confirm contamination conducted in wound clinic
  • Initial Debridement of wound conducted weekly by provider
  • Microlyte applied at evaluations 2-3x per week
  • An absorptive pad was placed over Microlyte and was used in conjunction with a fuzzy wale compression stockinet (EdemaWear®)
  • Oral or topical antibiotics were not administered

Clinical Outcome

A 36-month old venous statis ulcer (Fig. 1A) was treated with Microlyte® and a novel compression garment. Using compression alone, the wound responded favorably (Fig. 1B). The addition of Microlyte®, however, appeared to have a synergistic effect and the ulcer closed rapidly over a four-month period (Figs 1C-G). After 5 months of combined treatment with Microlyte® and a compression stockinet, the venous stasis ulcer now .5 x .5 x .1 cm (99.9% reduction in wound volume) with islands of epithelium in the base. The margins are contracting and surrounding skin is remodeling scar tissue.

Conclusion

Faster and more complete closure of a venous stasis ulcer was achieved by application of Microlyte® in conjunction with compression therapy using Edemawear® than was achievable with other failed therapies. This patient had significant comorbidities that had previously confounded healing of the venous stasis ulcer. The synergistic success of Microlyte® and EdemaWear® suggest promise in the treatment of venous stasis ulcers.

Figure 1: When wound presented, it had remains stalled for 36mo (Fig.1A). After initial compression treatment, some improvement was observed (Fig. 1B). After 5 months of combined treatment with Microlyte® and a compression stockinet, significant and rapid reduction of wound volume was observed (Fig. 1C-H), suggesting a strong synergistic effect between Microlyte® and EdemaWear®.