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Sacral Case Study: Leader, D

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Intrasite Conformable in the treatment of sacral pressure ulcers.

 

Introduction
Caring for patients with a pressure ulcer can be a challenging prospect, particularly when the patient is elderly. This challenge can be further enhanced when the patient is recovering from a broken leg and subsequently experiences discomfort in turning and lying on the side of the injury.

 

The Patient
Mrs P, at the age of 92, was admitted to the nursing home from her own bungalow. A year before she fell and broke her right femur and was hospitalised. She was being treated at home receiving weekly visits from the district nurse for a leg ulcer. Mrs P had developed a small sacral pressure ulcer which resulted in her GP referring her.


On admission, Mrs P was assessed using the Waterlow risk calculator. Mrs P had a risk score of 19, classifying her in the 'high risk' category. She was nursed in bed on her left side, as it was painful to be nursed on the right side due to the fracture. An airflow mattress was in situ. Mrs P was also undernourished and dehydrated, as a consequence blood was taken for assessment.

 

The Challenge
To manage a sacral pressure ulcer in an elderly patient.

 

Aims

  • To encourage healing without causing further damage to the wound.
  • To use a wound care product which would provide the optimum environment for wound healing.
  • To use a dressing which would be both easy to apply and remove, easing any associated pain.

 

Fig 1

 

Fig 2

 

Fig 3

 

Interventions
Intrasite Conformable was used as a primary dressing to gently pack the wound. A secondary dressing of Algisite* M was applied and fixed into position. This regime was changed on a daily basis. Over the period of the next five weeks (see Figs 1-5), the wound was successfully debrided and dressing changes then took place every second day.

 

Fig 4

 

Fig 5

 

Outcome
During the treatment, the dressings remained intact and no leakage of exudates occurred. The patient found the dressings comfortable and was therefore compliant with the treatment. The nursing staff were able to apply and remove the dressings easily. The wound was debrided easily and no pain was experienced during debridement. Over the period of the case study, the cavity became noticably smaller and should progress to healing.