Treating a chronic wound in a nonadherent patient: a case study

Limited evidence suggests that various formulations containing Balsam of Peru, castor oil, and trypsin (BCT) exert multiple actions that may promote wound healing such as shedding damaged skin cells, stimulation of localized blood flow, antimicrobial actions, and local analgesic actions.

An 81-year-old man was referred to our home-based wound care center for treatment of an excoriation-induced chronic dehiscence of an abdominal surgical wound. He had failed multiple topical therapies, primarily owing to persistent pruritus of the wound and periwound skin, resulting in removal of his dressing to scratch the wound and periwound skin. We used a spray containing BCT to promote wound healing and relieve pruritus; this addition resulted in wound closure within 38 days of treatment.

We recommend considering BCT spray when maintenance of dressing is impaired and wound healing delayed owing to pruritus. We found the BCT spray easy to use and well-accepted by our patient who was unable to tolerate other forms of topical therapy over a period of 6 months.