Clinical Case Study - Critical limb ischaemia - Mepilex Up®

Clinical Challenge

A 56-year-old male with type 2 diabetes presented with critical limb ischaemia. He had undergone a redo femoral distal bypass graft which subsequently occluded. He had received no further re-vascularisation. He had a fasciotomy wound. 

The wound was moderately exuding and contained 100% granulation tissue. He relied on crutches to stay mobile, but mentioned that the wound on his lower leg was limiting his movement. He also reported itching, further adding to his distress.

Intervention and Treatment Regime

After wound assessment, twice-weekly application of Mepilex® Up dressing, along with wool and crepe bandage, was selected to manage the wound exudate and promote healing.

Compression therapy was inappropriate due to peripheral arterial disease. It was determined that healing would be challenging due to the reduced blood flow to the leg.

Prior to each dressing application, the skin was washed with an emollient.

Wound Progression

Results

Mepilex® Up performance was found to be good overall, with no wound maceration noted. Ease of application and removal was considered ‘excellent’, with pain-free removal reported by the patient. The clinician observed that the dressing conformed well and emphasized that using a dressing significantly larger than the wound was not necessary to manage the exudate effectively.

The patient remained engaged with their treatment and wound healing progressed slowly. The clinician specifically highlighted the following benefits of Mepilex® Up:

• Easy application
• Safe application on fragile skin
• Effective management of high volumes of fluids
• Remained in situ
• Easy removal and gentle adherence to intact skin, ensuring pain-free removal
• Reduced visits, freeing up clinical time.

^{Acknowledgement: courtesy of Jane Todhunter, Vascular nurse practitioner, North Cumbria Integrated Care NHS Foundation Trust}