Using a superabsorbent dressing and antimicrobial for a venous ulcer.

In chronic wounds, exudate is believed to prolong the inflammatory phase and is detrimental to healing (Trengove et al, 1999; Vowden and Vowden, 2004). Poor exudate management can have important management cost implications, and may result in increased patient morbidity (White and Cutting, 2006). Accurate assessment of wound exudate is a key component of wound healing and management is achieved through different methods depending on the cause of the excessive exudate production. Superabsorbent dressings have been designed to treat highly exuding wounds; they have a greater fluid-handling capacity than traditional dressings and require changing less frequently (Tadej, 2009). This case study reports on the combined use of a superabsorbent dressing with an antibacterial dressing in a 102-year-old patient who presented with a painful infected venous ulcer complicated by some arterial disease. The combination of the superabsorbent KerraMax® (Crawford Healthcare) with the antibacterial honey Algivon® (Advancis Medical) created the ideal dressing for the treatment of this infected mixed aetiology ulcer, as manuka honey has a strong antibacterial effect (Molan, 1992), and the dressing absorbs the excessive exudate. The dressings worked together to reduce the bacterial load on the wound bed surface, with the honey selectively destroying the bacteria (Molan, 1992), and KerraMax absorbed and locked away the bacteria-containing exudate, which helped to reduce further exudate production, prevent maceration and reduce the potential for a wound to become malodorous (Hampton, 2011).