The use of the Eclypse Boot dressing on chronic oedema

Leanne Cook - Vascular Nurse Specialist, Pinderfields General Hospital

Mr W is a 44 year old man who was admitted to the medical unit generally very unwell, he was suffering from liver failure, cardiac myopathy, and renal failure. His lower limbs were grossly oedematous and the skin had begun to beak down in the week prior to admission.

Presentation

He presented with superficial ulceration to both legs which were heavily contaminated with pseudomonas; both limbs from the level of the knees down were leaking copious amounts of fluid both from the ulcer beds and the skin pores. This leakage was causing maceration, increasing ulcer size and excruciating pain to Mr W.

Method

First line treatment was to combat the pseudomonas infection but this was increasingly difficult due to his deteriorating medical condition and being unable to tolerate most dressing/topical treatments or compression due to the levels of pain he was experiencing. The aim of the initial management therefore was to promote comfort while preventing further maceration and subsequent ulcer expansion. Initially the use of foam dressing were used but these were unable to hold the copious amounts of fluid being expressed and required changing two or three times a day. At this point he remained in servere pain and the ulcer beds were advancing in size. This had a severe negative impact on Mr W quality of life as he found mobilising impossible due to a combination of pain and his bandages ‘dripping’ within a hour of dressing change. Eclypse Boot was commenced and within two days the nurses reported reduction in dressing change to only once a day, the Eclypse Boot held all the exudate with no strike through being seen after 24 hours; they were easy to use and dressing changes were mostly pain free. Within 5 days there was no further evidence of maceration and the ulcer edges had stopped advancing, more importantly Mr W reported significant reduction in his pain levels and seeing though the Eclypse Boot was holding all the exudate he was now able to mobilise without the embarrassment/discomfort of wet bandages.

Conclusion

The Eclypse boot is a ingenious design which has massive fluid handling proprieties therefore reduces the amount of dressing changes (reducing costs and relieving nursing time) whilst preventing maceration and improving patient comfort. In conclusion the Eclypse Boot is a cost effective dressing that significantly improves the quality of life in patients with highly exuding leg ulceration.