Use of chitosan-based dressings for the management of a chronic lower limb ulcer: a case report.

Introduction: Nonhealing ulcers are difficult to manage because they deviate from the normal wound healing process. The standard treatment with saline dressings is not efficient in treating patients with such wounds; advanced wound care dressings are needed. Chitosan-based advanced wound dressings are gaining popularity because of their unique characteristics, such as absorbency, conformability, and pain alleviation at the wound bed. A case of an ulcer that developed after cellulitis and healed with application of a chitosan-based dressing is presented.
Case Report: An 81-year-old female with hypertension was admitted to the hospital with a high-grade fever, generalized weakness, anorexia, and right lower limb pain with redness. Venous insufficiency in the right lower limb in the form of early insufficiency at the right saphenofemoral and saphenopopliteal junctions along with right leg varicosities was evident on color Doppler ultrasound. A diagnosis of cellulitis was made; the patient was treated with antibiotics and discharged from the hospital. The cellulitis progressed, and an incision and drainage of the right leg was performed on the second admission. The patient was admitted twice more, and the wound was surgically debrided twice and antibiotics were administered. During this period, the patient was treated with saline dressing changes for almost 4 weeks. Because the wound was nonhealing and infected during the fourth hospital admission, chitosan-based dressings were used. Daily dressing changes for 10 days resulted in 100% granulation tissue. Later, the patient underwent skin grafting and was eventually discharged.
Conclusions: The use of chitosan-based dressings resulted in progression to complete granulation, along with the management of exudate, pain, and Pseudomonas infection. The results of this case suggest patients with nonhealing ulcers may benefit from early use of advanced wound care dressings.