13 Feb Healing a Pressure Injury
Patient Overview
68 year old male with comorbidities of daily smoker, pre-diabetes, gout, hypertension, and hyperlipidemia who developed a deep pressure injury wound on his left heel that had been present for 4 weeks and another wound on his right 5th toe.
pressure injury treatment
Debridement, UltraMIST, skin substitutes, vascular intervention
wound presence
4 Weeks
time to heal
40 Weeks
wound progress
case presentation
68 year old male who has comorbidities of daily smoker, pre-diabetes, gout, hypertension, and hyperlipidemia was seen by Mendota Health after development of a deep pressure injury wound on his left heel that had been present for 4 weeks and another wound on his right 5th toe.
The heel was covered with thick dry eschar and was painful and the right toe wound was also painful.
assessment& Management
Patient was evaluated by a Mendota health nurse practitioner who diagnosed him with vascular disease and referred him to vascular intervention to retain blood flow to his lower extremities. He was hospitalized during treatment, and was given a recommendation for amputation of his 5th digit due to his wound being infected. The patient refused. After weekly assessment and treatment, the Mendota Health nurse practitioner was able to heal the wound on the toe.
The left heel pressure injury wound required advanced treatment for healing. After weeks of mechanical debridement and trimming of eschar, the nurse practitioner was able to clean the wound bed to advance healing. Utilizing a skin substitute and UltraMIST, this patient with comorbidities that impeded healing, was able to have all his wounds on his feet healed which decreased pain and allowed him to regain mobility.
The patient also received nutritional and smoking cessation counseling.
outcome
Impact of wound healing is decreased pain and increase of functioning allowing the patient to return to his normal daily routine.