Use of a four-layer bandage system in the treatment of an i.v. drug abuser with chronic upper extremity ulcerations: a case study.

A patient with a ten-year history of heroin abuse presented to a wound healing clinic for treatment of multiple ulcerations to his upper arm. The largest measured 3.5 cm x 1.7 cm. The patient related that these wounds came from his i.v. heroin use. Previous treatments included iodine packed gauze, saline soaked fine mesh gauze, dakins solution, and wet-to-dry dressings; all treatments were unsuccessful. Treatment included cleansing the wound with normal saline, packing the ulcers with a calcium alginate rope, and wrapping the arm using a four-layer bandage. The dressing remained in place for 7-day time intervals. During the course of treatment, the patient remained heroin-free. No unscheduled dressing changes occurred, nor did the patient report discomfort with the dressing or during dressing changes. The patient was able to maintain complete range of motion throughout care. Complete healing was noted by day 42. The calcium alginate dressing combined with the 4-layer bandage system has proved successful in treating the patient.