Complex local treatment of a patient with a sacral pressure ulcer in home care – case report

The article describes an effective treatment process of a grade IV/V pressure ulcer in the sacral region in a patient in home care. Initially, despite of the use of various methods of local treatment, the healing progress could not be achieved. To heal the pressure ulcer, local treatment was implemented according to the wound management concept, with particular emphasis on the wound hygiene concept. The basis of the wound management was formed by washing and cleansing the skin around the wound and preparation of the wound bed with products containing both surfactants and antimicrobial substances; in the described case – octenidine was chosen. In the process of skin protection around the wound as well as in the proper supply of the wound bed, products containing octenidine were used, including a dressing in the form of hydrogel with octenidine in combination with silver-containing dressing. The concept of comprehensive management of pressure ulcers presented in this article confirms the effectiveness of the wound hygiene concept and principally the significance of skin cleansing and of the proper wound bed preparation by the removal of bacterial biofilm and the inhibition of its growth, as the basic conditions of wound healing initiation. The use of appropriately selected modern dressings and antiseptics is of great importance in the treatment of pressure ulcers in chronically immobilized patients at home.