Case study: Unstageable pressure injury on heel

Wound type:

Pressure injury

Patient

80-year-old female

History

Living in a skilled nursing facility, Alzheimer’s Disease, type 2 diabetes mellitus, hypertension, coronary artery disease, anxiety, hyperlipidemia, anemia

91%

Enzymatic debridement over 27 days was associated with a 91% reduction in wound area*

*Individual results will vary

Wound presentation

When patient was first seen, right heel ulcer had initiated from pressure, but patient also presented with erythema and warmth at the wound site
The wound was initially cultured and treated with Bactrim™ DS orally and Aquacel™ Ag Dressing topically for 10 days
After the infection in the wound was treated, Aquacel Ag Dressing and Bactrim DS were discontinued

Treatment

The wound was cleansed daily using normal saline, then debrided, then SANTYL Ointment was applied covered with saline-moistened gauze, followed by a dry dressing

Dressings were changed daily and additionally as needed

Individual results will vary

Day 1

Aquacel Ag and Bactrim DS discontinued
SANTYL Ointment initiated
3.0cm x 5.5cm (depth undetermined)
75% necrotic tissue and 25% pink tissue

Day 6

2.2cm x 4.5cm (depth undetermined)
60% necrotic tissue and 40% pink tissue

Day 12

2.3cm x 4.2cm (depth undetermined); measured as one area with islands of epithelial tissue in the center
25% necrotic tissue and 75% pink tissue

Day 27

1.2cm x 1.3cm; 0.3cm depth; measured as one area with islands of epithelial tissue in the center
2% slough and 98% pink tissue
SANTYL Ointment discontinued
Hydrogel initiated to maintain a moist wound environment until full epithelization obtained

Result

91%