Innovative Treatment of Elbow Pressure Ulcer

The purpose of this poster is to discuss the use and benefits of a static air pressure relief boot used to treat a stage IV pressure ulcer on the elbow of a forty-nine year old, spinal cord injured adult male. Studies show that about 1/3 of spinal cord injured adults have pressure ulcers, which can lead to life-long complications affecting their general health and quality of life.
Initially, this patient had a stage II pressure ulcer on his right elbow, treated for one month with hydrogel and off-loading using synthetic sheep skin.  Air loss in his wheelchair cushion caused a seating imbalance.  The resulting loss of space between his arms and the armrest increased the pressure on his elbows.  The small Stage II then advanced to a Stage IV within six weeks. The seat cushion was repaired and seating imbalance was corrected.

To off load the elbow and provide for pressure redistribution we tried a new approach.  A static air pressure relief boot that is usually used on a patient’s foot and heel was applied to this patient’s arm.  His caregiver was educated on new wound care using calcium alginate and offloading.  The static air boot was kept on the patients elbow at all times to ensure total pressure relief. After four weeks of treatment, the wound decreased in size by over half, no undermining or bone exposure was present, and exudate was minimal. After three additional weeks, the elbow wound was completely closed despite a new onset of kidney obstruction that resulted in anemia and altered nutrition. This shows a healing rate of 100% over twelve weeks.

This unusual application has shown tremendous benefit to the patient in the case study, but this treatment could be generalized and used on patients with similar wounds.