(CS-018) Copper dressings to the wound rescue after everything else failed

Cernica Weitman, RN, MA – Chief Wound Care Nurse, Hadassah Medical Center, Jerusalem, Israel; Tohar Roth, MSc – MEDCU TECHNOLOGIES LTD

Introduction: A 58-year-old patient with a past medical history of Systemic Lupus Erythematosus since 2004, hypertension and hypothyroidism, suffered from a painful 1.6 sq. in. ulcer above the malleolus medially right leg, apparently from an insect bite, when she was hospitalized (September 2019). Despite a wide range of different wound healing treatment modalities applied, after 9 months of hospitalization the wound increased to ~120 sq. in. The treatments applied included negative pressure wound therapy, pressure chamber sessions, two skin grafts, application of antimicrobial wound dressings, and steroid, immunoglobulin and antibiotic administration. All skin layers were eliminated all the way to the muscle, below the knee in the front and side sides of the leg. Amputation below the knee was contemplated at this stage.

Methods: Copper oxide dressings (COD)* were applied and changed every 2-3 days. Cleansing gel⁰ was applied at every dressing change for 15 minutes. No antibiotics or any other wound treatment was applied.

Results: While initially there were high amounts of wound exudate, the amount of secretions gradually decreased. In parallel, granulation tissue started to appear in the wound edges together with new epithelia crawling from the wound edges, covering the muscle. The size of the wound gradually decreased and the patient experienced significant reduction in pain. Thirty-four days later the patient was finally released to home after being hospitalized for almost 10 months. The wound continued to be treated in the wound clinic with the COD, which was replaced with a fresh COD every 3-4 days. After 3 months of treatment most of the wound was covered with epithelia. While the wound was still not completely closed after 7 months of COD treatment, strikingly, gradually new skin tissues were formed beneath the covering epidermal layer reducing significantly the wound depression.

Discussion: Resolution of the wound progression, subsequent granulation tissue formation, epithelialization, wound healing and almost complete wound closure- was achieved only after treatment with copper oxide impregnated wound dressings. This case strongly supports the potential role of copper in the healing process of hard-to-heal wounds.