Problem and Past Management This case study is an example of using a combination of Negative Pressure Wound Therapy with a 100% Sodium Carboxymethylcellulose (Na CMC) fiber dressing with ionic silver. The patient was a 64 year old female patient with a surgical flap of a nonhealing stage IV pressure ulcer on her left ischial process.

Protocol of Care A combination of a 100% Na CMC fiber dressing with ionic silver and NPWT was initiated at 80mmHg continuous suction. The silver dressing was selected as the wound was at risk of infection due to the location and the potential contamination from urine and feces. The wound base was cleansed with normal saline, the pre-moistened dressing was placed in direct contact with the wound bed. Finally, the suction set and secondary dressing was applied, dressing changes were biweekly.

Results Initial wound measurements were 15cmx9cmx8cm (LxWxD). In 10 weeks, the wound size decreased by 90% and the wound depth decreased by 96%. At that time, NPWT was discontinued. The 100% Na CMC fiber dressing with ionic silver dressing was continued and electrical stimulation by the Physical Therapist was added until the wound had remodeled itself.

Product Notations *Versatile 1 Negative Pressure Wound Drainage System †AQUACEL( Ag dressing