Long-term debridement effect of denervated large sacrococcygeal pressure injury: A case report.

ABSTRACT

RATIONALE Complicated pressure injury in paraplegic patients is common and difficult to manage. Previous case studies have documented short-term management; however, little is known regarding suitable approaches to long-term clearing of extensive pressure injury in the sacrococcygeal area under denervation. PATIENT CONCERNS A 53-year-old man was bedridden for 1.5 years owing to cervical vertebral fracture-dislocation (C5-C6), resulting in extensive sacrococcygeal pressure injury. DIAGNOSES On admission, he presented with the injury complicated by infection (stage IV necrosis), and his vital signs were unstable. INTERVENTIONS: The infection was treated with a range of antibiotics, including clindamycin phosphate, metronidazole, cefoperazone sodium, and sulbactam sodium. Debridement of the pressure injury was performed, helping remove the necrotic tissue and stimulate tissue regeneration. OUTCOMES: The patient was discharged after 88 days of hospitalization. The extent of the pressure injury at discharge was reduced compared with that at admission. At 4-month follow-up, the injury was nearly healed, with no signs of any further complications. LESSONS This case study suggests that wound debridement is a cost-effective and clinically efficacious approach to long-term complicated pressure injury management.