Case 2
Pressure Ulcers
- 45-year-old woman.
- She has become paraplegic following a complex scoliosis procedure at the age of 19.
- She had been an active person until pandemic.
- In 2019, she fell down and broke her vertebra and underwent surgery.
- vFollowing the surgery, pressure injury on the right trochanteric region has developed.
Patient History
- She was first treated by a wound care nurse
- During the treatment the wound got infected and patient had septicemia
- The patient was admitted to hospital for antibiotic treatment
- An orthopedic surgeon treated her wound.
- During her stay, the orthopedic surgeon debrided the wound twice in a week and used negative pressure wound treatment for 15 days
- After NPWT, the patient had been operated for 3 times
- In the last two operations, the surgeon had tried to close the wound with special anchor sutures inside and closed the wound edges primarily
- The sutures detached every time
Clinical Course
- After last procedure, the patient was referred to our clinic
- All the sutures were removed and the wound was debrided
- There were huge gaps (nearly 10 cm) in 11 and 6 o’ clock directions
- The trochanteric part of the os femoris was exposed
- During debridement tissue samples were obtained and sent to microbiological culture; which then revealed no bacterial colonization
- NPWT was initiated
Clinical Course II
- The foam was changed twice weekly
- NPWT was stopped after 3 weeks as the exudation discharge decreased below 30 cc/ day
- The gaps decreased by half at the end of NPWT
- Vulnamin treatment was initiated
Treatment
The vulnamin powder and cream treatment was initiated.
Following powder application, the wound bed and the gaps were filled with cream by using a spatula.
The wound was covered with standard foam dressing (coloplast biatain silicone foam).
The application and the dressing change was performed every other day.
Results
- In 6 months, the bone is totally covered with granulation tissue
- The gaps decreased to 3 cm length
- The wound bed is now ready for flap surgery
Dr. Ozker in Pressure Ulcers
Case 3
78 year
Following the surgery, pressure injury on the right trochanteric region has developed.
View the case