Question

Local wound care for a patient with venous insufficiency ulcer consists of once weekly appication of moisturizing lotion to intact skin, an amorphous hydrogel, and gauze covered with a compression wrap. On the next clinic visit, you notice the edges of the wound are macerated causing the wound to increase in size. To what do you attribute this finding?

Answer 1

Maceration and enlargement of a venous insufficiency ulcer are often due to excessive moisture, which can occur from over-application of hydrogel or inadequate gauze, leading to impaired healing and expansion of the wound.

Step-by-step explanation:

The maceration of the wound edges and the increase in wound size in a patient with venous insufficiency ulcer can be attributed to excessive moisture in the wound environment. When a wound dressing retains too much moisture, such as from an over-application of an amorphous hydrogel or insufficiently absorbent gauze, the surrounding intact skin becomes overly hydrated. This leads to maceration, which appears as softened, white, and pruned skin making the tissues more susceptible to injury and infection. This condition can impede the healing process and cause the wound to expand. Proper wound care requires a balance of moisture that promotes healing while protecting the surrounding skin from excessive moisture.