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

Introduction

The aim of this series was to evaluate the celerity of a Bioactive Microfibre Gelling (BMG™) dressing (MaxioCel) used in direct contact with the wound bed to debride devitalised tissue, manage exudate, reduce bioburden, promote granulation, reduce odour and reduce pain. Standard PU care (regular repositioning and pressure redistribution equipment) also applied.

Method

The evaluation period varied between 14 days to 28 days, and was conducted across our acute hospital trust, with patients being reviewed by the tissue viability team. Trust protocol was followed, and patient consent gained.

Results

  • Patient 1 : Debridement completed, pain substantially reduced, outstanding levels of granulation and advancement of edges.
  • Patient 2 : Necrosis debrided, bioburden, pain, exudate levels, slough, overall diameter and depth considerably reduced.
  • Patient 3: Eschar detached from edges, enabling conservative sharp debridement. Underlying devitalised tissue reduced.

 

Case Study

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

Category 4 pressure ulcer Initially measuring 17.8 x 5.6cm, depth unknown. 95% necrosis, 5% slough to edges, locally infected. High levels of haemopurulent odorous exudate. Pain level 10 out of 10.

At 28 days, 100% granulation. 75% decrease in wound surface area. Pain score reduced from 10 to 4 within 28 days.

MaxioCel was straightforward to use and well tolerated, accelerated debridement without discomfort, managing exudate and inflammation effectively.


Conclusion

Effective wound debridement removes devitalised tissue, senescent cells and bacteria, stimulating growth factor activity and promoting healing. The patients selected for this trial were particularly challenging due to their complex comorbidities, advanced age, general deconditioning and poor healing potential. The BMG dressing (MaxioCel) was straightforward to use and well tolerated, accelerated debridement without discomfort, managing exudate and inflammation effectively. 

 

To see the full poster, presented at EWMA 2024, including more details on the case study highlighted, download below.

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References 

Jacqui Fletcher ’National Wound Care Strategy update: Pressure ulcers prevention and the PSIRF exemplar’ Wounds UK, Vol 18, No4, 2022,. Afzali Borojeny et al. “The Incidence of Pressure Ulcers and its Associations in Different Wards of the Hospital: A Systematic Review and Meta-Analysis.” International journal of preventive medicine vol. 11 171. 5 Oct. 2020, doi:10.4103/ijpvm.IJPVM_182_19.