Treatment of full-thickness pressure ulcers with a gentamicin sponge: a case report.

BACKGROUND: Five pressure ulcers (stage III and stage IV) were successfully treated with collagen sponges filled with gentamicin. CASE DESCRIPTION: All ulcers occurred in an immobile 94-year-old woman with advanced dementia. One of the pressure ulcers, located on the patient's sacrum, was considered life-threatening due to size and depth. All ulcers were treated with a collagen sponge filled with gentamicin; the sponge was replaced at variable intervals, ranging from 6 days to 2 months, depending on absorption of the collagen. All 5 pressure ulcers improved based on reductions in wound depth and surface area. Two of the pressure ulcers healed completely; in these wounds, gentamicin sponge therapy was initiated shortly after development of the ulcer. None of the wounds exhibited evidence of reinfection following initiation of therapy. No adverse events were observed. The rate at which the collagen sponge was absorbed slowed significantly after the initial treatment phase. CONCLUSIONS: In this patient, the use of a collagen sponge filled with gentamicin was effective in preventing infection and promoting healing of multiple full-thickness pressure ulcers. Long-term use was not associated with any adverse effects, even in this frail and immobile patient.

[Difficulties in diagnosing Graves' ophthalmopathy--case report]. / Trudnosci w rozpoznawaniu orbitopatii tarczycowej--opis przypadku.

PURPOSE: The aim is to present diagnostic difficulties which may occur when diagnosing Graves' ophthalmopathy. MATERIAL AND METHODS: 49-year-old woman, who had been smoking 20 cigarettes a day since she was 21 years old, treated for Graves' disease for 14 years, with the right eyeball protrusion existing for 6 months, dysfunction of eye movements and diplopia, was admitted to the Diabetes and Endocrinology Center in Bydgoszcz. After ophthalmological examination the patient underwent MRI and USG of the orbits which showed a change in the inferior rectus muscle of the right eye which could correspond to orbit tumor. In the Ophthalmology Department of the Medical Academy in Bydgoszcz the opening of the orbit was carried out in order to confirm or to eliminate the neoplastic process. RESULTS: Surgery and control examinations excluded neoplastic process. CONCLUSION: It is very difficult to differentiate between inflammatory infiltration and neoplastic tumor in patients with unilateral protrusion in the course of Graves' ophthalmopathy.