Nonsurgical management of pressure injury with a new silicone rubber negative pressure wound therapy with instillation device: a case report.

Abstract

Background: Surgical debridement and flap-based reconstruction are essential procedures for managing stage 3 and 4 pressure injuries (PIs). However, the recurrence of PIs after flap reconstruction is high; moreover, many patients cannot tolerate surgical management.

Case report: An 81-year-old male presented with 3 stage 4 PIs (1 each on the sacral region and heels) that were successfully treated without surgical management. The patient was bedridden with progressive dementia, pneumonia, and malnutrition. He could not tolerate thorough debridement. A new silicone rubber negative pressure drainage tube with instillation device was applied to the wounds on the right heel, left heel, and sacral region for 20, 25, and 80 days, respectively, until the wounds were filled with healthy granulation tissue. This device comprises a principal, a connector, an instillation, and a negative pressure drainage tube. The principal part of the device is made of medical-grade silicone rubber shaped into a columnar structure; there is also an instillation channel in the center of the principal tube, forming an instillation loop and ensuring the whole wound is thoroughly instilled. The wounds treated in this case healed without thorough debridement or flap-based reconstruction and had not recurred as of 1-year follow-up.

Conclusion: Wound healing was achieved without thorough debridement or flap reconstruction, using a new silicone rubber anti-blocking negative pressure wound therapy with instillation device that was able to remove thick exudate and slough.