Case studies are great resources for those looking to better understand all aspects of wound care.
Each year, a volume of case studies are published by the greater wound care industry. While patterns may repeat during research – specifically in regards to patient behavior and specific medical practices and techniques – each case is unique and offers new and vital information for patients and caregivers alike. Here are two more case studies worth mulling over:
Case Study No. 1
(Courtesy of Australian Wound Management Association)
62 years old – Female
History of diabetes mellitus and Addison’s disease
In addition to the two chronic conditions, the patient had previously suffered from high cholesterol, issues with diminished eyesight and minor cardiovascular disease. When she first entered a local Australian wound clinic, the patient had spent the previous two years dealing with seven ulcers spread across her upper thighs, shins and calves. The largest of these ulcers measured 32 millimeters in width and 45 mm in length. Previous treatments, which included injections of hydrocortisone and several forms of dressings, had almost no effect on the ulcers. Tests on one of the ulcers came back positive with necrobiosis lipoidica diabeticorum, an infection that causes painful rashes. The patient experienced varying degrees of pain; at one point, her personal ratings hit the 10 mark. From there, the patient was put on a strict treatment plan that involved several diet modifications – including more zinc – and the use of compression bandages, hyperbaric oxygen therapy, hydrogel dressings and diabetic control therapy. Most of the wounds closed within just a few sessions of HBOT, while the final two healed in two months. The patient was then scheduled for several follow-up visits over a three-month period.
Case Study No. 2
(Courtesy of Northern Arizona University)
43 years old – Male
No discernible history
Following a high-speed collision in the early 2000s the patient was diagnosed with a severe spinal fractures, resulting in paraplegia. In the years that followed the accident, the patient was admitted to the hospital several times for a series of non-healing pressure ulcers, notably in in the rear and lower portions of his pelvic girdle. On one particular visit to his usual wound care clinic, the patient had developed a series of complications – namely deep tunneling and sever undermining across the pelvis. The ulcers had also become infected by several bacterial strains, including streptococcus and enterococcus faecalis, which had made their way into the bones, causing osteomyelitis. At one point, the ulcers became infected with methicillin-resistant staphylococcus aureus, a bacterial strain that is ultimately impervious to most traditional antibiotic treatments. Given the severity of the infection, the doctors were forced to disarticulate the right femur in addition to performing a high above-knee-amputation of the entire lower right leg. The remaining stage IV ulcers in the pelvis were then treated with a standard round of antibiotics and wound dressings for a period of several months.
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