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Rare and atypical: long-term pyoderma gangrenosum healed in an elderly rheumatoid arthritis patient with multiple comorbidities

4/10/2018

1 Comment

 
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We are excited to present one of the more recent cases where a rare condition – pyoderma gangrenosum wound - has been healed in 6 months with Enluxtra after displaying no progress for over 4 years with other products.

Who is the patient?
Our patient is an 86-year-old female suffering from rheumatoid arthritis and comorbidities including hypertension, chronic obstructive pulmonary disease, sleep apnea (non-compliant with CPAP), congestive heart failure, and gout. Her severely painful ankle wound common with her autoimmune condition has been present for over 4 years and confirmed as pyoderma gangrenosum via punch biopsy.

Previous treatment she had
Our patient has been treated at outpatient wound care clinics and used the help of home care nurse. Her previous treatment included enzymatic and antibacterial ointments and cream, honey-based and silver-based products, alginates and sharp debridement.

Switching to Enluxtra
​After years of unsuccessful treatment attempts our patient could no longer tolerate surgical debridement and was frustrated with no progress. She was recommended to give Enluxtra a try and chose to self-treat, initially purchasing the dressings from Amazon and then obtained a prescription to be filled via a DME supplier.

Progress and healing with Enluxtra
Enluxtra dressing was started with a daily 6”x6” dressing application overlapping generously onto the skin around the wound. The patient cleansed the wound and peri-wound area with an HOCL wound cleanser and applied Enluxtra, and then secured it with cotton netting.
Daily dressing changes were performed at the beginning of treatment, and then change frequency was gradually reduced and adjusted to the condition of the dressing drainage pattern, state of the wound, patient’s comfort and level of drainage that fluctuated due to comorbidities. 
This elderly patient has been able to treat her own wound successfully with the regular help and advice of the medical professional knowledgeable about Enluxtra dressing with whom she communicated via phone and email. 

​Scroll down to view photos of wound progress and clinical notes.

Learn more about Enluxtra
  • View  Enluxtra case studies to see how it can heal the most difficult, stubborn wounds that resisted previous treatment with other products.
  • Find out about Enluxtra difference.
  • To buy Enluxtra dressings visit our online store, or explore other purchasing options.
  • Order free samples available to medical professionals.
  • ​​​Read other posts in our blog.

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Week 0. At presentation and before Enluxtra treatment was started. The patient started applications of 6"x6" Enluxtra dressings.

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Week 2. ​Within two weeks of Enluxtra applications, wound edges and peri-wound started looking healthier. The wound still had a lot of bioburden and it was recommended to the patient to improve the contact of Enluxtra dressing with the wound bed to facilitate the removal of biofilm. The patient started placing some 4”x4” folded gauze on top of Enluxtra to press it down and then applying a cotton tubular elastic net bandage over it. 

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Week 7.  By the middle of week 7 the wound bed was flattened and wound edges started contracting. The peri-wound was dry but healthy. Daytime pain decreased to level 1-2 out of 10. Night time pain level varied from 5 to 7. Some pain relief could be achieved when changing the leg position to dependent (below the level of the heart). This was likely ischemic pain due to the patient’s poor circulation. 

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Week 13.  Epithelial cell migration continued to bring the wound edges closer together. It was advised to the patient that this important stage of healing required extra care with dressing application and removal in order to protect the fragile new tissue growth.
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Week 23. Continued Enluxtra dressing applications with variable change frequency (dependent on the patient’s comfort level) brought this atypical wound to full re-epithelialization and closure.

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Read other posts in our blog.
1 Comment
Ayesha Mark link
12/28/2018 11:00:45 pm

Thanks for this blog, it is very informative. keep posting more wonderful blogs like this.

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    This blog is an online hub for new and seasoned ENLUXTRA "Any Wound" users, and for those curious about this next generation of advanced wound dressings - Self-Adaptive Wound Dressing. Find out about the company and the product, about our achievements and successes, and share your own stories.  ​

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