Venous leg ulcer of the anterior left tibia

Patient
71-year-old male with a history of hypertension, mitral valve insufficiency, hepatic encephalopathy, and cirrhosis of the liver.

Wound presentation
A venous ulcer developed on the left anterior tibia after discontinuing use of medication, causing extreme edema. The skin was shiny, thin, and hairless.

Treatment
Weekly sharp debridement, followed by cleansing with lactated Ringer's solution and application of Collagenase SANTYL Ointment. Between visits, wound was cleansed and SANTYL Ointment and an antibiotic cream were applied daily, and wound was covered with a dressing.

Venous leg ulcer at baseline with 80% yellow fibrotic and 20% beefy red granular wound base

 Individual results will vary.

DAY 1

  • » SANTYL Ointment initiated

  • » 8.9 cm x 6.7 cm; 0.3 cm depth

  • » Moderate erythema and no odor

  • » 80% yellow fibrotic and 20% beefy red granular wound base

  • » Beige slough covering the 20% beefy red granular wound base

  • » +2 edema present to the lower extremity

Venous leg ulcer (pre-debridement) at day 19 with 30% white fibrotic and 70% beefy red granular wound base. Individual results will vary

DAY 19 PRE-DEBRIDEMENT

  • » 7.8 cm x 4.6 cm; 0.2 cm depth

  • » Mild erythema and no odor

  • » 30% white fibrotic and 70% beefy red granular wound base

  • » +2 edema present to the lower extremity

Venous leg ulcer (post-sharp debridement) at day 19 with 100% beefy red granular wound base. Individual results will vary

DAY 19 POST-SHARP DEBRIDEMENT

  • » Moderate erythema and no odor

  • » 100% beefy red granular wound base

  • » +2 edema present to the lower extremity

Venous leg ulcer at day 26 with 100% beefy red granular at wound base and 100% epithelialization at the proximal 2/3 of the ulcer. Individul results will vary

 Individual results will vary.

DAY 26

  • » Mild erythema and no odor

  • » 100% beefy red granular wound base

  • » Beige slough covering 60% of granular wound base

  • » +2 edema present to the lower extremity

  • » 100% epithelialization at the proximal 2/3 of the ulcer, resulting in 2 separate ulcerations

Venous leg ulcer at day 42 with 100% beefy red granular at wound base with 100% epithelialization at the proximal 2/3 of the ulcer. Individul results will vary

DAY 42

  • » Mild erythema and no odor

  • » 100% beefy red granular wound base

  • » +2 edema present to the lower extremity

  • » 100% epithelialization at the proximal 2/3 of the ulcer, leaving one final portion of the ulcer

  • » SANTYL Ointment discontinued

Results

There was 100% epithelialization at the proximal 2/3 of the ulcer, leaving one final portion of the ulcer.


Collagenase SANTYL Ointment is indicated for debriding chronic dermal ulcers and severely burned areas.

Occasional slight transient erythema has been noted in surrounding tissue when applied outside the wound. One case of systemic hypersensitivity has been reported after 1 year of treatment with collagenase and cortisone. Use of Collagenase SANTYL Ointment should be terminated when debridement is complete and granulation tissue is well established.

For more details, please see complete prescribing information.