Case Study: Managing Mixed Aetiology Leg Ulcers with Superabsorbent Dressings and Gentle Compression

This case study examines the successful management of a complex, longstanding leg ulcer with both venous and arterial elements. Using gentle compression, precise debridement, and a superabsorbent dressing, healing was achieved within just 90 days. It restored comfort, dignity, and quality of life for the patient.

Case Study: Managing Mixed Aetiology Leg Ulcers with Superabsorbent Dressings and Gentle Compression. Patient and carer.

Understanding Mixed Aetiology Leg Ulcers

Mixed aetiology leg ulcers are chronic wounds caused by a combination of venous insufficiency and arterial disease. This dual condition significantly complicates wound healing. On one side, venous hypertension leads toWhat is an Arterial Leg Ulcer?, article on absorbest.co.uk oedema and excess wound exudate. On the other side, arterial insufficiency restrictsArterial leg ulcer treatment, article on absorbest.co.uk oxygen and nutrient supply to the tissues, impeding the body’s natural healing process.

It’s estimatedOptimal treatment strategy for mixed arteriovenous leg ulceration - Journal of Vascular Societies that ulcers with mixed aetiology make up approximately 15–25% of all leg ulcers in the UK. Accurate assessment, including measuring the Ankle-Brachial Pressure Index (ABPI), is essentialUnlocking ABPI: effectively assessing ABPI and the implementation of automated ABPI for lower-limb wounds in community nursing, Wounds UK, Vol. 21, Issue 01 for identifying arterial involvement and determining safe levels of compression therapy

Challenging moisture balance

Managing moisture balance is often one of the most significant challenges. Excess exudate risks maceration of the surrounding skin and increases the likelihood of infection. Meanwhile, insufficient moisture can dry out the wound bed, hindering healing. Choosing the appropriate dressing, often a superabsorbent one, alongside suitable compression therapy, plays a vital role in promoting healing.

Accurate diagnosis is crucial, as treatment involves balancing compression for venous issues without aggravating poor arterial circulation. Personalised, holistic care is essentialMixed Aetology Leg Ulcer, article on absorbest.co.uk for achieving successful outcomes.

Treating these wounds effectively is vital not only for physical healing but also for restoring dignity and comfort in everyday life. Every step towards recovery lessens pain, prevents complications, and helps patients regain independence. For caregivers, selecting the right approach can transform a situation that once seemed hopeless into one of progress and relief.

“What is a mixed aetiology leg ulcer”, absorbest.co.uk

Study and patient history:
An 87-Year-Old Patient with a Long-Standing Mixed Aetiology Leg Ulcer

An 87-year-old woman, living with multiple illnesses and both arterial and venous insufficiency, faced a persistent wound that remained unhealed for 240 days. In this case, the ulcer was stuck in the inflammatory stage, producing large amounts of exudate that leaked onto clothing, bandages, and bedding. Delicate peri-wound skin, maceration, and ongoing inflammation created a cycle that was difficult to break.

Treatment Approach: Debridement, Superabsorbent Dressings and Light Compression

Wound preparation and dressing selection

The initial step involved thorough cleaning and debridement to remove yellow fibrin and biofilm, making the wound bed more receptive to healing. Local anaesthesia was administered to minimise discomfort during the procedure.

A superabsorbent dressing (DryMax Super) was chosen due to its capacity to:

Efficiently absorb and retain exudate, decreasing the risk of maceration.
Keep in close contact with the wound bed because of its softness and ability to conform.
Absorbs effectively under pressure, making it suitable for compression therapy.

Compression therapy:

Given the patient’s arterial condition, only gentle compression therapy was used, based on ABPI (Ankle-Brachial Pressure Index) assessment and clinical judgement.

Treatment routine mixed aetiology leg ulcer

Treatment routine:

The dressing was precisely sized to fit the wound.
During periods of high exudate, dressings were layered (stacked) to control fluid peaks.
Scheduled dressing changes were planned once or twice weekly, depending on exudate levels.
The interval between changes could be lengthened, giving the wound more time to rest and heal.
Local anaesthesia was administered to facilitate thorough cleansing and debridement of fibrin and biofilm.

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Clinical Results: Healing Progress Over 90 Days

The combination of effective exudate management and controlled compression resulted in several beneficial changes:

The wound started to heal, showing a clear move away from the inflammatory phase.
Maceration resolved due to improved moisture balance.
No infections took place during the treatment period.

Progress in healing of hard to heal exuding wound.

Clinician and patient, positive outcome of mixed aetiology leg ulcer treatment.

Patient and Clinician Perspectives

Patient’s improvements:

The patient was able to resume a more active daily routine, with fewer dressing changes and no longer experiencing leaking wounds or damaged clothing. She also reported that the dressing was pain-free, both when in place and during changes.

Simplicity for the clinician:

The superabsorbent dressing proved reliable, cost-effective, and easy to handle. No emergency dressing changes were needed. The ability to stack dressings allowed flexibility during fluctuating exudate levels.

Overall, the product was recommended for inclusion in the local wound treatment protocol, outperforming previous dressings used for similar wounds.

Key Learnings for Managing Mixed Aetiology Leg Ulcers

This case highlights the importance of:

Accurate assessment of wounds (including vascular status)
Effective management of exudate with superabsorbent dressings
Appropriate compression according to ABPI results
Patient-centred care that prioritises comfort and quality of life

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A superabsorbent primary dressing

Experience the difference and compare the outcome with our superabsorbent dressing. Designed to create a simple wound healing process and optimal healing environments to support clinicians giving quality care.

A dressing enables longer wear time and fewer dressing changes
For use on exuding wounds, works well under compression
Available on the NHS Supply Chain and Drug Tariff

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Promoting treatment of problematic leg ulcers

What are the characteristics of different leg ulcers, and how can we promote the healing of problematic ulcers? Treatment measures, phases of healing, cleaning, and appropriate dressings. Our complete guide to leg ulcers focuses primarily on venous ulcers, from cause and origin to the healing process and aftercare.

Download the guide now