Wound Bed Preparation in the Management of an Extensive and Infected Leg Ulcer, in a Patient with Multiple Co Morbidities

The case report presents the case of 45 years old female patient with multiple associated diseases sent for treatment to the Plastic Surgery Department, for multiple, extensive and infected left leg ulcer. In addition to systemic treatment, the patient has undergone multiple surgical procedures, debridement of the wound and then split skin grafting. The general treatment and the wound bed preparation prior to skin grafting have required a special attention, given the fragility of the patient condition and the obstacles to wound healing due to local and general deleterious factors. In order to ensure adequate local conditions for grafts integration, the proper wound bed preparation has consisted in serial debridement and application of topical agents with anti-infective, anti-inflammatory and nutritive activities, like medicinal honey dressings. The local and general evolution has been gradually favorable, with the remission of the leg phlegmon and stage integration of split skin grafts.