An evaluation of Actilite - Antibacterial non-adherent dressing with Activon Plus: Case study 3

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

Case study 3

Female patient with chronic lower leg lyphoedema and recurrent cellulitis

85 year old lady with chronic lower leg lymphoedema, obesity, type 2 Diabetes mellitus, arthritis and history of recurrent cellulitis.

Due to ill fitted shoes and diabetic neuropathy patient has developed grade 2 pressure ulcer to left foot, medial aspect of 1st MTH, size 2cm x 2cm. On initial assessment the ulcer appeared inflamed, erythematous, with moderate serous exudate, increased local pain and surrounding maceration. Both legs were grossly oedematous with deepened skin folds, hyperkeratosis, papilomatosis and red inflamed skin to dorsal aspects of both feet.

Actilite was applied to left foot ulcer and both feet - dorsal aspect, to provide antibacterial properties, reduce inflammation and encourage ulcer healing. The dressings were secured with padding and toe to knee retention/crepe bandages. Dressings were changed every three days, while this was incorporated into regular skin care routine i.e. washing of both legs in warm tap water to remove skin debris and moisturising dry, scaly skin with emollient.

8 days later: left foot pressure ulcer has fully epithelialised and erythema has subsided.

Following ABPIs which showed good vascular supply, lymphoedema treatment continued with 3 - 4 layer compression bandaging and skin care. In this case the use of Actilite resulted in reduced inflammation, allowed ulcer to heal, improved skin texture, prevented development of cellulitis.