Rapid Closure of a Traumatic Lower Extremity Wound in a High-Risk Geriatric Patient Using Adaptive Moisture Control Wound Dressing

Abstract

​A 90-year-old patient with multiple comorbidities, including diabetes mellitus, venous insufficiency, and cardiovascular disease, presented with an acute lower extremity wound following traumatic removal of a compression wrap. The wound was characterized by inflammation and moderate exudate. Adaptive moisture control wound dressing (Enluxtra® Self-Adaptive) was initiated in home health care setting to manage exudate and protect fragile periwound skin using adaptive moisture control. Rapid progression toward closure was observed, with complete epithelialization achieved by Day 11. This case highlights the potential role of adaptive moisture control dressings in managing complex wounds in high-risk patients.

Patient Profile

  • Age: 90 years
  • Relevant comorbidities:
    • Diabetes mellitus (insulin-dependent)
    • Hypertension
    • Renal insufficiency
    • Heart insufficiency
    • Hyperlipidemia
    • Chronic venous insufficiency
The patient represents a high-risk population with impaired healing capacity due to vascular compromise and metabolic disease.

Wound Etiology and Presentation

The wound developed following traumatic removal of a wrap applied with compression therapy, resulting in tissue injury.
Initial clinical presentation (Day 0):
  • Inflamed wound bed
  • Moderate exudate
  • Fragile periwound skin
  • High risk of further skin damage due to age and comorbidities

Intervention

An adaptive moisture control wound dressing (Enluxtra® Self-Adaptive, 6×6 in) was selected with the following goals:
  • Effective exudate management
  • Protection of fragile wound edges and periwound skin
  • Maintenance of a balanced moist wound environment

Clinical Course

Day 0 (July 9, 2023) – Initial Application

  • Wound assessed as inflamed and exuding
  • First Enluxtra dressing applied
  • Objective: stabilize wound environment and protect surrounding tissue

​Day 1 (July 10, 2023) – First Dressing Change​
  • Dressing removed for evaluation
  • Findings:
    • Periwound skin intact and protected
    • Effective exudate management
  • Wound measured
  • New Enluxtra dressing applied
Day 2 (July 11, 2023) – Second Dressing Change​
  • Wound bed stable
  • No deterioration of wound edges
  • Continued effective exudate control, with vertical absorption pattern observed (see the removed dressing photo on the right side)
  • Decision made to extend wear time to 5 days, indicating adequate exudate handling capacity
Day 8 (July 16, 2023) – Third Dressing Change
  • Wound closure observed
  • No visible exudate
  • Dressing reapplied to:
    • Support newly formed tissue
    • Protect against mechanical disruption
    • Promote continued skin remodeling
Day 11 (July 19, 2023) – Outcome
  • Complete wound closure maintained
  • No complications reported

Outcomes

  • Rapid progression to closure within 11 days, 4 dressings applied.
  • Effective exudate management throughout treatment
  • Preservation of fragile periwound skin
  • No reported maceration or edge breakdown
  • Extended wear time achieved without compromise of wound condition

Discussion

This case demonstrates successful management of an acute traumatic wound in a medically complex geriatric patient, a population typically associated with delayed healing.
Key observations include:
  • Atraumatic interaction with wound and periwound tissue, critical in fragile skin
  • Efficient exudate handling, allowing for extended wear time
  • Maintenance of a balanced moist wound environment, supporting epithelialization
The rapid closure observed may be attributed to the dressing’s ability to adapt to wound conditions, balancing moisture without causing desiccation or maceration.

Conclusion

In this high-risk elderly patient, the use of an adaptive moisture control wound dressing was associated with:
  • Rapid wound closure
  • Protection of fragile skin
  • Simplified wound management with fewer dressing changes

These findings suggest that adaptive moisture control dressings may be a valuable option in managing complex wounds where both exudate control and tissue protection are critical.