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The rubber sponge dressing, originally suggested for the treatment of varicose ulcers, is apparently being used to treat all forms of ulceration of the leg. Such a policy must inevitably lead to therapeutic disappointments. Recently I have had occasion to observe several ulcers of the leg for which treatment with the rubber sponge had been employed initially. In all cases the history was the same: The pain and discomfort had been increased, and/or the discharge had become more profuse. Analysis of these cases showed one or two factors responsible. In some cases the sponge had been applied to a gangrenous ulcer; the pressure exerted by the sponge then tended to make the ulcer more ischemic and consequently more painful. In other cases the sponge had acted as an occlusive dressing and the resulting exudation had caused extensive maceration of the contiguous skin.
In the treatment of ulcers of the leg