Here - EWMA 2013

POSTER PRESENTATIONS
POSTER: CASE STUDY
P 384
P 385
Poster: Case Study
Poster: Case Study
* Enzyme Alginogel ®
TREATMENT OF INFECTED ISCHEMIC DIABETIC FOOT ULCERS WITH AN
TREATMENT OF A PRESSURE WOUND WITH AN ENZYME ALGINATE DRESSING*
ENZYME ALGINATE DRESSING
Kasia Huisman 1
Liam Stoeldraaijers 1
1 Brabant Zorg (Al Oss, Netherlands).
1 Podotherapie Valkenswaard (Valkenswaard, Netherlands).
Aim: The aim of this case was to investigate whether an enzyme alginate dressing*
Aim: In patients with diabetes and PAD, ulcers usually develop in conjunction with minor could be integrated in the current wound protocol based on the efficiency of the enzyme
(shoe-related) trauma. The combination of infection and PAD is a major risk factor for alginogel in treating yellow wounds.
lower leg amputation. Topical wound management is adjunctive to systematic and
Method: An 82 year old man suffering from Alzeimer’s, bad vision, cardiac problems,
surgical treatment. Sometimes, conservative therapy is the only option. Debridement of
hypertension as well as Strumpell disease developed a pressure wound on the lateral
necrotic and fibrin tissue, promoting wound healing, trying to avoid amputation of the
plantar surface of the foot. This was caused by foreign material inside his orthopedic
foot and patient comfort are the main goal in this case.
shoe.
Method: A 79 year old male diabetic patient developed two shoe-related diabetic foot
The wound was closed, having formed a pocket containing pus. Two days later, the
ulcers with signs of infection on the right hallux. MRA showed an occlusion of the
wound became infected and the patient was treated with antibiotics. The wound was
superficial femoral artery. Revascularization was no option. Conservative treatment by a
opened and debrided up to the fascia. The wound was then further treated with regular
podiatrist specialized in diabetes was started and included temporary footwear, optimal
cleansing and application of an enzyme alginate dressing* in the wound, covered by a
diabetes control and oral antibiotic therapy with clindamycin. An enzyme alginate
secondary dressing. Additionally, an offloading device was also put in place.
dressing* was applied on both wounds and covered with a highly absorbent cotton and
polyester fibre pad. Wound debridement was performed weekly, and wounds were
Results: After one week, the wound was clean and filled with granulation tissue. After 2
cleaned and washed daily with saline.
weeks, the wound had reduced by 50% in size and after 4 weeks, the wound had closed
Results: A significant improvement of both wounds was observed. After 6 months, the
completely.
wound bed of one wound was actually closed and an amputation of the foot was
Conclusions: This case, together with results from other cases, has shown that enzyme
prevented. Treating the ulcers with an enzyme alginate dressing* created a moist wound alginate dressings are highly efficient in the treatment of yellow wounds and are thus
environment and continuous debridement of fibrin and necrotic tissue was obtained,
integrated fully in our local wound protocol.
together with painless wound care for the patient.
*Enzyme Alginogel
Conclusions: The clinical outcome illustrates the effectiveness and the comfort of an
enzyme alginate dressing* in the treatment of infected ischemic diabetic foot ulcers with
poor prognosis of ulcer healing.
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