Clinical Case Study - Sacral wound - Mepilex Up®

Treatment

A 59-year-old male presented with a large sacral wound following an unwitnessed fall. The patient had a high body mass index and a history of type 2 diabetes and arterial foot ulcers.

Surgical debridement was undertaken to reveal a large, category 4 pressure ulcer to his sacrum and across both buttocks. The wound was initially managed with negative pressure wound therapy. However a degree of over-granulation was recorded and fresh bleeding noted. At this stage, the treatment plan was reviewed, and conservative management with antimicrobial dressings was implemented.

A highly absorbent dressing was required; however, the wound's location presented a significant challenge in achieving a secure fit in hard-to-seal areas. Additionally, the patient reported skin tenderness upon dressing removal. At this stage, it became clear that the patient needed a dressing capable of managing high levels of exudate, minimising the risk of maceration, providing comfort with pain-free removal, and ensuring that

Wound Progression

Results

By week 2, an improvement was noted in the wound bed, along with healthy epithelial tissue. No further bleeding was observed and wound exudate remained fully contained within the Mepilex® Up dressing. Mepilex® Up was also found to be atraumatic upon removal. During week 2, the patient was able to sit with the support of a therapist, and also engaged with essential rehabilitation.

By week 3, the skin surrounding the wound had healed. The patient reported no tenderness and noted an improvement in their condition. Wound healing was expected to continue, including in the coccyx region. Additional patient outcomes may be reported at a later date.

^{Acknowledgement: courtesy of Luxmi Dhoonmoon, Nurse Consultant Tissue Viability, London North West University Healthcare NHS Trust. Images copyrighted to the London North West Healthcare NHS Trust.}