My goal of care with this six‑week‑old wound on this very anxious patient was to support healing while limiting aggressive debridement to try to mitigate her anxiety. Therefore, the wound hygiene protocol was initiated … I first cleanse the full wound area, including the peri-ulcer skin, with a noncytotoxic antiseptic wound cleanser. Then, I sharply debrided that hard, a sharp cap that you see, and dry fatty necrosis as tolerated by the patient … Then, I refashion the rolled wound edges by abrading the epidermis to promote flattening of the epiboly. Then, I ordered daily dressing changes within an enzymatic debrider … The wound hygiene treatment protocol promotes attention to all aspects of a wound’s healing … read more