Use of the vapor permeable membrane for cutaneous ulcers: details of application and side effects.

Vapor permeable membranes (VPM) are commonly being used to treat cutaneous wounds where partial or full thickness skin is lost. Five years of experience with one particular VPM has taught a great deal concerning its proper use. Correct preparation of the treatment site to allow adhesion followed by application of the VPM with the right amount of tension and border are of paramount importance or aggravation rather than improvement of the cutaneous defect may occur. Initially, the membrane should be changed frequently, once or twice a day in heavily contaminated or necrotic wounds. Side effects are usually related to improper application, with resultant leaking of fluid and irritation of normal skin. Recent success has been achieved by weekly application of VPM in the office, removal at home after several days, and subsequent use of 10% benzoyl peroxide lotion until the next office visit. Extreme caution must be exercised if VPM is used to treat patients who are severely leukopenic or malnourished.