A 94-year-old diabetic patient
Effective management of a heel pressure ulcer (HPU) that is locally infected is challenging, especially with the rise of antibiotic-resistant infections and patients’ reluctance towards surgical intervention. Therefore, innovative and alternative approaches need to be explored.
A 94-years-old patient with bilateral stage III HPU
A 94-year-old male patient presented with a bilateral stage III HPU caused by permanent immobility and aggravated by a prolonged hospitalization related to uncontrolled diabetes.
The patient had several comorbidities, including diabetes, cerebrovascular disease, depression, prostatic hypertrophy, anemia, and deficiency of vitamin B12. Previous treatments were not reported by his relatives.
Initial assesement
The initial examination was held 10 days after his dismission from the hospital, where the right HPU measured 6cm in length, and 5cm in width, and his left HPU measured 7cm in length, and 7cm in width.
Local infection was evident by the presence of large heels defect, extended necrosis, heavy exudate, malodor, erythema, pain, and delayed healing.
L-Mesitran treatment of heel pressure ulcer
The initial therapeutic protocol included serial surgical (scalpel) debridement at the bedside with a 2-week interval in between, followed by the application of L-Mesitran® Soft wound gel (MGH), L-Mesitran® Tulle (MGH) and a foam dressing.
MGH dressing changes were performed at the patient’s home daily by his relatives to permit effective drainage of the exudate and achieve an osmotic cleansing of the wound bed from the extended necrotic tissue.
Results
After 8 weeks of combined treatment, clinical signs of infection were resolved, and the wound bed was noticeably cleansed, and new granulation tissue started to fill the heel defect. Since the healing process progressed successfully, the dressing was changed every 3 days. Finally, complete HPU healing was achieved after 155 days of MGH treatment without complications.
