The acronym "DOMINATE" as a necessary instrument in the treatment of a patient with a venous ulcer

Abstract

Among the ulcers of the lower extremity, it is those of venous etiology that occur most frequently. The acronym TIME is often used in the treatment of this type of injury as a tool to help prepare the wound bed. In 2014, with a much more comprehensive view of the care of patients with this type of injury, the acronym DOMINATE was introduced.
This work is developed with the objective of describing the nursing interventions carried out during the treatment (January to May 2019) of a patient with a venous ulcer using the acronym DOMINATE as an ulcer management tool.
In the initial phase of treatment, enzymatic and autolytic cleaning and debridement were performed. Subse-quently, to reduce oedema, manage exudate and facilitate healing, calcium alginate dressings and non-adhesive hy-dropolymeric secondary dressings were used under low elasticity bandages. The cures were held on Mondays, Wednesdays and Fridays.
The monitoring of wound evolution was carried out through photographic records (after informed and written consent of the patient), and in addition the RESVECH scale was used to control the evolution of the lesion, which (which was initially 15 and was decreasing to its full resolution). Overall, the patient’s glycosylated haemoglobin levels dropped from 8.8 to 6.6%, and the pain score (using the EVA scale) went from 5 to 1 in two months.
After the follow-up period we conclude that taking into account all the parameters covered by the acronym DOMINATE is very useful when deciding and planning the care of patients with venous ulcers.