Exudate Management of a Patient With Multiple Wounds & Extensive Oedema

Introduction

The World Union of Wound Healing Societies (WUWHS) Consensus Document highlights wound exudate plays a vital role in the wound healing process, making effective exudate management an essential component of care. This case study describes the management of a patient (Image 1) with multiple comorbidities, including cardiac disease and obesity. As a result of these comorbidities and reduced mobility spending most of their time in a chair, the patient presented with multiple wounds to the toes and feet, extensive bilateral leg oedema, and very high wound exudate levels. The clinician also suspected a concurrent fungal infection.

Compression therapy was applied and was changed daily due to the amount of exudate present. The compression therapy was eventually stopped due to the amount of exudate present. The patient was unable to tolerate prolonged periods of leg elevation, presenting additional challenges to effective oedema and exudate management. Following a holistic assessment, the clinician selected a dressing regimen aimed at managing the excessive exudate, reducing the risk of maceration, and improving patient outcomes.

Method

Following dermatological assessment, a topical antifungal treatment was prescribed to manage the severe fungal infection. The clinician selected Eclypse Foot and Eclypse Non-Backed dressings to manage the patient's high levels of wound exudate.

Eclypse Foot is a highly absorbent, high-capacity wound dressing designed to effectively manage moderate to very high levels of exudate. It absorbs fluid, helps reduce the risk of leakage, and minimises the potential for peri-wound maceration. Has a water-resistant backing with a high moisture vapour transmission rate, helping to prevent strike-through while maintaining an optimal wound environment and extending wear time (Image 2).

Eclypse Non-Backed (Image 3) is a non-backed superabsorbent dressing featuring double CrystaLock Technology. Its soft, flexible outer layer allows the dressing to conform closely to the contours of the foot while providing high levels of fluid absorption and retention.

The dressing regimen was continued for two weeks, after which the patient's progress and clinical outcomes were reviewed and documented.

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Image 3

Results

Image 3 demonstrates the patient's wounds on Day 1 following the commencement of the dressing regimen. Owing to the very high levels of wound exudate, the clinician selected Eclypse Non-Backed as the primary dressing and Eclypse Foot as the secondary dressing (Images 4, 5 and 6). Following two weeks of treatment, the clinician reported positive clinical outcomes (Image 7). These included an improvement in the peri-wound skin, a reduction in maceration, and increased dressing wear time. As exudate levels reduced, the frequency of dressing changes decreased from three times daily to once every 2–3 days, reducing the burden of care while maintaining effective exudate management. With dressing time reducing from three times a day to once every three days is 88.1% saving in clinician time.

Discussion and Conclusion

This case demonstrates that, following a comprehensive holistic assessment, selecting an appropriate superabsorbent dressing regimen can improve the management of high levels of wound exudate. Although superabsorbent dressings are commonly used as secondary dressings, this case showed that using Eclypse Non-Backed as the primary dressing in combination with Eclypse Foot as the secondary dressing was associated with effective exudate management, reduced peri-wound maceration, and extended dressing wear time. The reduction in dressing changes from three times daily to once every 2–3 days represented an approximately 88% reduction in dressing changes over the two-week evaluation period. This reduction has the potential to decrease nursing time, minimise disturbance to the patient, and improve the overall efficiency of wound care.

In conclusion, despite the patient's complex presentation, including cardiac disease, obesity, extensive oedema, reduced mobility, and an inability to tolerate compression therapy, noticeable clinical improvement was observed within 14 days. The clinician reported improvements in peri-wound skin condition, reduced maceration, and improved dressing wear time. These findings suggest that the combination of Eclypse Foot and Eclypse Non-Backed dressings may be an effective option for managing high levels of wound exudate as part of a holistic, patient-centred approach to care.

References

1. World Union of Wound Healing Societies (WUWHS) Consensus Document. Wound exudate: effective assessment and management Wounds International, 2019