PROBLEM:     A 56-year-old ventilator-dependant patient with history of C5-C6 quadriplegia had non-healing pressure ulcers to the right ischia and left trochanter.

PAST MANAGEMENT:         Admitted (more than five years previously) to the facility with pressure ulcers, his wounds waxed and waned with changes in his medical condition.  Both wounds had been managed with silver hydrofiber*, hypertonic sodium chloride dressing**, and enzymatic debriding agent***.  He had been maintained on a low airloss/alternating air mattress with head of bed greater than 45 degrees secondary to ventilator-acquired pneumonia protocol.

CURRENT APPROACH:  On May 21, 2007 new dressings were implemented.  A collagen wound dressing with alginate**** was placed to the right ischia wound (Wound A).  A pure collagen wound dressing***** was placed to the left trochanter wound (Wound B).

OUTCOMES:  One week after initiation, Wound A had 46% decrease in area.  Wound B had 61% decrease in area.  Two weeks after initiation, Wound A declined to 18% decrease in area.  Wound B had improved to 82% decrease in area.  Six weeks after dressing initiation, Wound A had 70% decrease in area and Wound B had 100% decrease in area (closure).  Shortly thereafter, the patient died secondary to complications from sepsis.

CONCLUSION:         Collagen product B***** promoted more complete wound closure than collagen product A**** in this patient with two pressure ulcers.

DISCLOSURE:  If accepted for presentation, expenses will be defrayed by Medline, Inc.

* Aquacel Ag (ConvaTec)

**MeSalt (Molnlycke)

***Accuzyme (Healthpoint Medical)

****Fibracol Plus (Johnson & Johnson)

*****Puracol (Medline, Inc.)