Case Study: Category 4 pressure ulcer


Patient history

A 92-year-old female with hypothyroidism, hiatus hernia, asthma, MRSA, aortic stenosis, long standing neuropathy to bilateral lower limbs.

The patient was admitted to hospital after a fall, with a right distal femoral fracture and sacral DTI.

The patient lived alone, independent with ADLs, supported by family. 

Initial assessment

At initial assessment a category 4 pressure ulcer (deteriorated from DTI) to sacrum was identified.​ The pressure ulcer measured 7.8 x 5.6cm, depth unknown.

The wound bed was 95% necrotic, with 5% slough to edges, and was locally infected.

High levels of haemopurulent odorous exudate were present. Patient reported her pain level to be 10 out of 10. 


MaxioCel was commenced with treatment aims to debride, reduce bioburden, reduce pain and manage exudate.

Daily dressing changes were undertaken due to anatomical site and risk of contaminants.  A sacral foam bordered dressing was used as a secondary dressing and barrier film applied to the periwound. 


Within 10 days use of MaxioCel an improvement in the wound bed condition was noted with all necrosis debrided. 10% fibrinous slough and 90% granulation to wound bed was noted. Serous exudate was present.

​Within 28 days use of MaxioCel the wound bed was much improved with 100% granulation present. A 75% decrease in wound surface area was recorded.


After 28 days use of MaxioCel, the wound was 100% granulated and the patient pain levels had reduced from 10 to 4.

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Within 28 days use of MaxioCel, wound was 100% granulated, and patient reported pain levels had reduced from 10 to 4.

Within 28 days a 75% decrease in wound surface area was recorded.


Severe Pressure Ulcer Debridement in the Acute Sector : Case Study Series to Support a Change in Clinical Practice