Original publication by: M.-J. Hutter

vasomed aktuell 1991; 4: 50-54

This case study describes the use of CUTINOVA^◊ hydro for the treatment of 10 patients with leg ulcers.

One of the patient cases described in the following study is Janice Bond, a 52-year old woman who has had a severe ulcer on her lower left leg for more than 6 months.

The photographs below were taken on admission to hospital and after 14 weeks of treatment with CUTINOVA^◊ Hydro.

We treated 10 patients with leg ulcers with CUTINOVA^◊ Hydro wound dressing in combination with our standard therapy (compression bandages and laser treatment) over a period of 40 days. In 9 out of 10 cases, use of the wound dressing was an improvement on the usual treatment. The overall assessment of the findings and results of the treatment with the wound dressing was good.

These are the results of a study of the use of a CUTINOVA^◊ Hydro wound dressing which was carried out in the period from August 5 to September 14, 1989, in the Braunschweig phlebology center. In this study, we examined the behavior of wounds and the progress of healing of leg ulcers in 10 patients. The patients were selected at random in order to cover as wide a range as possible and to include the problems which are common in a clinic specializing in vein disorders. The treatment was applied to pretibial, lateral or medial malleolar and bimalleolar ulcers associated with a postthrombotic syndrome or chronic venous insufficiency, ranging from 1 x 0.5 cm to 5 x 6 cm in size. All the lesions were necrotic, and many of them had bacterial infection and were putrefying. One patient had the additional complication of AOD, and another had cortisone-damaged skin in the treatment area. All 10 patients received additional treatment with compression bandages and laser techniques. The CUTINOVA^◊ Hydro wound dressing contains highly absorbent particles which are embedded in a self-adherent polyurethane matrix. The dressing is covered by a water-resistant polyurethane film which is permeable to oxygen and water vapor. It is flexible enough to be molded to fit all regions of the body.

We tested the wound dressing for the following: ease of application; adhesion; changing the dressing; pain/adhesion to the wound; absorption of discharge; cushioning effect; assistance with cleaning and granulation of the wound.

On use of CUTINOVA^◊ Hydro in combination with compression bandages and laser treatment all the leg ulcers healed without complications in a period of 10-40 days. As expected, treatment of large and bimalleolar ulcers, which were up to 5 x 4 cm and 4 x 8 cm in size, and of infected putrefying lesions took longer. The average healing time for the ulcers treated with CUTINOVA^◊ Hydro in combination with our standard therapy (compression bandages and laser treatment) was 22 days.

The dressing had to be changed once or twice a day (average 1.6 times a day) on the ulcers, most of which were putrefying with bacterial infection. The ease of application was assessed as very good in 3 out of 10 cases, good in 4 cases and satisfactory in 3 cases. The adhesion was very good in 7 cases and good in 3 cases. The changing of the dressing was assessed as good in 9 cases and satisfactory in 1 case. The absorption of wound exudate was very good in 1 case, good in 7 cases and satisfactory in 2 cases. The cushioning effect was very good in 2 cases, good in 7 cases an satisfactory in 1 case. The assistance with wound healing and granulation was very good in 1 case, good in 7 cases and satisfactory in 2 cases. Use of CUTINOVA^◊ Hydro proved to be exceptionally beneficial in the patient with AOD because the gentle compression necessary in this case was assisted by the good cushioning effect of the dressing and it was possible to use the latter very effectively. Only in a few patients the use of CUTINOVA^◊ Hydro was not an improvement on our standard therapy. The cortisone-damaged skin was lifted up, and this was associated with pain, when the dressing was changed. This led to an initial increase in the size of the lesion.

A series of photographs is used to document the progress of healing of an extensive leg ulcer.

Overall, the behavior of the wound and the progress of healing of the leg ulcers treated with CUTINOVA◊ Hydro can be stated to be good, and the wound dressing has advantages compared with our standard therapy to date.

In 9 out of 10 cases, use of the wound dressing provided a distinct advantage in combination with or by comparison with our standard therapy.