Multiple Clinical Applications of a Dialkylcarbamoyl Chloride (DACC)-Coated Dressing in the Management of an Extensive Skin Defect: A Case Report

Dialkylcarbamoyl chloride (DACC)-coated dressings physically bind and remove microorganisms through hydrophobic interactions and are widely used for various types of wounds, ranging from acute to chronic.However, few reports have comprehensively described their practical applications across different stages of wound management.We report the case of an 86-year-old woman with extensive skin necrosis of the lower extremity in whom DACC-coated dressings were used for four distinct purposes: as a standalone dressing, as a contact layer during negative pressure wound therapy (NPWT), as a contact layer for a skin graft, and as an interface with cadexomer iodine ointment.After debridement, a Sorbact ® Gel (ABIGO Medical AB, Askersund, Sweden) dressing maintained a moist wound environment and facilitated healthy granulation without clinical signs of infection.During NPWT, a Sorbact ® Compress was used as a contact layer, resulting in a wound bed suitable for skin grafting without clinical infection.A Sorbact ® Gel dressing was subsequently used as a contact layer over the skin graft, which achieved satisfactory engraftment.For the remaining highly exudative wound, a Sorbact ® Compress was used in combination with cadexomer iodine ointment, providing adequate exudate management while preventing direct adherence of the ointment to the wound surface and pain during dressing changes.The wound ultimately healed without clinical infection, with a favorable outcome at seven months after skin grafting.This case illustrates the versatility of DACC-coated dressings and their potential to serve different therapeutic purposes according to the requirements of each stage of wound management.