Mango cut incision for pressure ulcer necrotic tissue clearance: An easier and safer method to facilitate chemical debridement in severely-comorbid patients

Abstract

Background

Treatment of pressure ulcer with necrotic tissue formation is challenging in old patients with severe comorbidities. Although indicated and recommended, surgical debridement cannot always be applied because of general conditions. Simple, convenient, and minimally invasive intervention is required to facilitate chemical debridement of necrotic tissue.

Methods

Seventeen patients suffering from intractable pressure ulcer complicated with necrotic tissue formation underwent conventional debridement (CD) or mango cut incision (MCI). Feasibility of MCI method was evaluated by comparing clinical outcomes between patients who underwent CD and MCI.

Results

Between patients undergoing CD and MCI, there was no significant difference in time for necrotic tissue clearance (3.1 ± 2.0 vs. 4.0 ± 1.5 weeks, P = 0.366), nor in time for pressure ulcer cure (14.7 ± 6.2 vs. 12.7 ± 5.6 weeks, P = 0.566). Time required for intervention was significantly longer in CD than that in MCI (173.8 ± 44.5 vs. 29.4 ± 13.3 s, P < 0.001). CD procedure was associated with significantly higher rate of bleeding compared with MCI (38% vs. 0%, P = 0.043).

Conclusions

MCI allows minimally invasive clearance of necrotic tissue with clinically acceptable outcomes compatible to CD, and can be a choice of method for necrosis-complicated pressure ulcers in patients with severe comorbidities.