Provide optimal standard of care based on best practice to improve patient outcomes, by removing necrotic tissue, addressing infection, social and emotional problems and preventing patient from further surgical intervention.

Rationale:

Comorbidities such as SCI/neuromuscular problems, nutritional, social and emotional to name a few are things that can significantly change the outcomes of a patient. We will present a young SCI patient with paraplegia, S/P MVA in 1985, with surgical repair of a Stage IV pressure ulcer in 1989. Admitted July 4, 2005 with a Stage IV, necrotic, foul smell, extensively infected pressure ulcer covering the entire sacral, right trochanteric, perianal and vaginal vault area as well as bilateral foot ulcers. Her past history is unclear, unable to determine prior treatment regimens prior to presenting to our setting.

Methodology:

Patient admitted with malformed buttock, anus and vaginal vault making any treatment option difficult. It was necessary to address infection, reduce bioburden, and promote healing. Patient with urinary and fecal incontinence, as well as monthly menses, added to problem with choosing an appropriate advanced wound care dressing. We will demonstrate with this case the progression towards healing by utilizing advanced wound care products that are bioavailable to cleanse, debride, reduce bioburden and maintain an optimal moist environment.

Results:

Able to reduce ulcer size, promote granulation tissue, prevent infection, and improve nutritional status.