Combination Use Of A Bioresorbable Silver Matrix And An Unna Boot To Treat A Non-Healing Lower Extremity Wound

Background: A 74-year-old female patient presented with a traumatic wound to her left lower leg that was non-healing for 1 month. Previously, she was treated with silver sulfadiazine. On initial assessment, her wound measured 1.9 x 2.2 cm, and the wound bed was fibrogranular with overlying slough, and periwound erythema was present without any other signs of infection.

The patient was treated with systemic antibiotics one month prior to initial visit, due to suspected infection. Comorbidities included hypertension, and edema with adequate perfusion of the involved lower leg. A bioresorbable silver matrix (Microfilm Matrix)* was used to provide a template to support reepithelialization, and to manage bioburden underneath an Unna boot.

Methods: The patient’s wound was first debrided under anesthesia, then Microfilm Matrix was applied as the contact dressing once a week under an Unna boot for 3 weeks.

Results: One week after combination treatment with Microfilm Matrix and an Unna boot, the patient’s wound measured 1.7 x 1.2 cm, a 51% reduction from 1.9 x 2.2 cm. At week 2, the wound was 84% healed at 0.8 x 0.4 cm, and at week 3, the wound was 100% reepithelialized.

Conclusions: Despite the patient’s advanced age, history of infection and co-morbidities, use of Microfilm Matrix and an Unna boot worked together to accelerate wound closure. Importantly, the patient is very active in her community and was able to get back to her daily activities.