Case Study: Pseudomonas Infected Leg Wound

A 45 year old female crashed through a glass door and had a deep wound on her left ankle, severing the achilles tendon and nerve. Her leg was put in a cast for 6 weeks. After one and a half weeks, the specialist noticed that the wound was infected. The cast was left on and the infection was identified by a swab as a pseudomonas species.

After 6 weeks, the cast came off and the wound infection was bigger. Acetic acid compresses were applied daily. This had little to no effect on reducing the infection. 

The wound treatment changed to L-Mesitran Ointment because of its known antimicrobial activity against Pseudomonas species —  debriding capacity and wound healing characteristics

The patient rinsed the wound herself with water/saline and then applied the L-Mesitran Ointment directly on the wound. This was covered with regular gauze, which did not adhere to the wound.

At the start of the Ointment treatment, the wound surface (±4 x 3.5 cm) was covered with 50% slough. The wound started to produce more exudate in the first days of the ointment use. After 5 days into the ointment treatment, the slough decreased. After 7 days, the wound decreases roughly 20%. 

After 2 weeks, the smaller wound was healed. Probably due to prolonged wound exudates, some maceration can be observed at the wound edges. 

In 5 weeks, the wound reduced 78% in size, from ±14 cm² to ±3 cm². The wound further decreased in size and completely healed in 2 months.

The patient did all the dressing changes herself, without any need of home care nurses. She reported no pain while applying the ointment and found it easy to use. She also reported that in the latter part of the wound healing she regained sensation in the wound area, indicating the repair of the severed nerve in her ankle.