Something old, something new in wound dressingsBMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7546.916-a (Published 13 April 2006) Cite this as: BMJ 2006;332:916
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Editor. I would like to support the views expressed by P J Mahaffey
I have seen quite a number of elderly passengers arriving to start a
cruise with ulcers on their lower limbs. Almost all these ulcers were
being treated at weekly intervals for several months by a wound care nurse
using "leave in place" dressings. They all arrived with packs of the
expensive "leave in place" dressings. The ulcers were invariably infected
On board management was to dress the lesions every 2 to 3 days. The
ulcerated areas were cleaned with betadine and sterile water. An
impregnated gauze was applied to the lesions and covered with Mellolin,
gauze swabs and an elastic bandage. At each change, the old dressings
were very carefully removed, using sterile water to ease each layer off
any adherent areas. On some occasions, after the dressing was removed,
the ulcerated areas were left open to the air for a couple of hours before
the new dressing was applied.
Despite the usual cruise being only 2 weeks, all the lesions showed
improvement. One who had started with infected, weeping ulceration on
both legs below the knee, about 3 hands area on one leg and 2 hands area
on the other, left the ship after 2 weeks with both legs completely
healed, except for one small patch about 2.5cms in diameter where
epithelialisation was not yet complete.
One elderly patient, who was systemically toxic, confused and
beligerent on arrival, rapidly became calm and mentally completely normal.
This was old fashioned management, but it worked. Some old wound
management ideas are making a comeback, namely maggots for necrotic
lesions. Perhaps P J Mahaffey may eventually see EUSOL make a comeback.
Evan L Lloyd
Competing interests: No competing interests