An evaluation of Actilite - Antibacterial non-adherent dressing with Activon Plus: Case study 1

This study was undertaken by Jivka Dimitrova - Tissue Viability Specialist Nurse. The University Hospitals of Leicester NHS Trust

Case study 1

Elderly female patient with chronic venous leg ulceration

87 year old lady admitted to hospital with an extensive CVA. She had previous history of chronic venous ulceration of right lower leg which has been treated by her district nurses using different dressing regimes and three layer compression bandaging with little effect. 

Upon initial assessment by tissue viability, the patient presented with a 3cm x 2cm full thickness skin ulcer to right medial gaiter area and two smaller ulcers, proximal to the first ulcer. All ulcers were superficially sloughy but not infected, exuding high levels of serous fluid causing white maceration and irritation of surrounding skin. As patient suffered with psoriasis, there were multiple psoriatic lesions and hyperkeratosis to both feet and gaiters. 

Following a three week treatment with Actilite dressing to ulcerated areas and three layer compression bandaging (changed weekly) all ulcers were fully healed, skin texture improved considerably and some of the psoriatic plaques have disappeared. Patient was discharged to a Nursing home with weekly maintenance compression therapy and skin care. Due to general deterioration and development of chest infection, patient was readmitted to hospital two weeks after initial discharge. Her right leg had also deteriorated, she had new, small but red inflamed ulcerations to her shin, and what appeared to be pustules to plantar aspect of her foot. Again Actilite was applied to all new skin damage/irritations and three layer compression bandaging was reapplied to aid venous return. One week later all signs of skin infection had disappeared and ulceration had healed. No further primary dressings were required but weekly skin care and maintenance compression were continued.