Mrs EY is an 81-year-old widow with two sons and six grandchildren. She is a retired teacher. She was a keen golfer, and although unable to play anymore following hip replacement surgery, she remains an active member of the golf club’s social club. She is also a regular bridge player.
Mrs EY had her leg ulcer for 12 months before being referred for treatment to the Leg Ulcer Service. She reported that “looking after the wound took over my diary” due to regular appointments with the practice nurse for treatment at her GP surgery.
The ulceration also impacted on her activities of daily living, such as showering and getting dressed. She stated that these activities “took much longer”, which impacted on her ability to function properly in terms of physical wellbeing. She also had to organise her shopping trips for quieter times of the day due to “anxiety about bumping the wound site, especially in supermarkets”.
Assessment and treatment prior to commencing Accel‑Heal®
Mrs EY attended her first appointment at the leg ulcer clinic on 29 September 2013. She had chronic ulceration in the gaiter region of the right lateral leg of 12 months’ duration. The onset of her first ulcer was 10 years previous and she had experienced approximately two episodes of ulceration per year since that time.
Erythema and oedema of the periwound skin was noted. Her ABPI was 1.1 and she had a high pain score of 8–10/10 on the VAS scale. Full compression bandaging was commenced but due to her high pain score and episodes of reoccurrence, Accel‑Heal® was discussed with Mrs EY and a decision was made to commence treatment with the objective of reducing the pain and inflammation, and to reducing the risk of reoccurrence in the future.
Treatment and outcome
Mrs EY commenced her treatment with Accel‑Heal® on 8 October 2013. Treatment ran for 12 days alongside compression therapy. Mrs EY was trained to independently change the device every 48 hours.
By 11 October, the ulceration had decreased in size by 10%. The exudate level had reduced, and periwound erythema and oedema had resolved. Mrs EY reported a reduction in pain, measuring 6/10 on the VAS scale. On 15 October, the ulcer had reduced in size by 20% and the patient’s pain was 5/10 on the VAS scale.
By 18 October, the ulcer had shrunk by approximately 30% since 8 October. Accel-Heal treatment was completed on 22 October.
Since the commencement of treatment, the ulcer had shrunk in size by 40%. At this time, Mrs EY reported a pain score of 2/10. Three weeks post Accel‑Heal® treatment, the ulcer had reduced in size by 80% and her pain was 0/10 on the VAS scale.
The Accel‑Heal® treatment had successfully achieved its objectives of reducing the pain and inflammation, and as a result she was able to tolerate compression therapy. The ulcer progressed to full healing on 14 November.
During the Accel‑Heal® treatment, Mrs EY stated that “I could see my wound improving almost immediately and for the first time in a year, I felt hopeful that it would heal”. With her ulcer now healed, Mrs EY feels that she has her life back and can “shop when I want to”.