A severely obese patient with chronic venous insufficiency (CVI) and hypertonia

A severely obese patient with chronic venous insufficiency (CVI) and hypertonia, in this case the defects are of combined aetiology. On lower abdomen with extensive defects caused by sagging skin flabs Tecasorb application was followed by complete healing. Ulcerations are present on both lower legs.

Left lower leg:

1. The skin on the left lower leg is cleansed with gauze pads soaked in cleansing solution
2. The skin is dry with minor central crusts.
3. Scales and crusts are removed painlessly with a single use curette
4. Since there is no defect, the skin is covered with a thin layer of indifferent zinc ointment
5. Hydrophilic bandage is applied

Right lower leg:

1. The wound bottom of the minor defect is moistened with cleansing solution
2. The defect is then cleansed using Debrisoft, a special pad used to efficiently remove fibrin debris from the wound bottom
3. The adjacent skin is covered with a thin layer of indifferent ointment (in this case zinc ointment with olive oil)
4. Tecasorb dressing is applied
5. Hydrophilic bandage is applied
6. Compression bandage is applied at the end. Patient may also use compression stockings; in this case, however, it is complicated.