Treatment of a Complex Pressure Ulcer Using a Synthetic Hybrid-Scale Fiber Matrix.

Pressure ulcers are caused by sustained pressure, friction, or shear on the skin which limits blood flow to the dermis and surrounding tissue. Symptoms include redness and ulceration and may result in a chronic wound. This ailment affects three million adults in the United States, and is a major burden to the healthcare system. Pressure ulcers are associated with pain and immobility that substantially lower the patient's quality of life, resulting in longer and more frequent hospitalization and a higher risk of mortality. As the severity of the pressure ulcer increases, it becomes more challenging for clinicians to successfully treat the wound and achieve healing objectives. Treatment of a pressure ulcer is more challenging when the wound is associated with infection, heavy exudate, inflammation, high enzymatic activity, and exposed bone and/or muscle. An advanced technology that may provide a new solution for the treatment of pressure ulcers is the use of a biodegradable synthetic hybrid-scale fiber matrix. The synthetic hybrid-scale fiber matrix provides a porous scaffold for cellular infiltration and vascularization that leads to granulation tissue formation and re-epithelialization, before completely resorbing via hydrolysis. In this case report, a patient who had a large sacral pressure ulcer present for over 16 years with two exposed spinal segments and exposed peritoneum was treated with the hybrid-scale fiber matrix. A total of nine applications of the material were applied over 11 weeks. The wound demonstrated significant healing, wound exudate was notably reduced, and no complications were observed. New epithelial tissue formation, tissue coverage over the exposed bone, infection management, and wound exudate reduction were observed to the extent that the patient was discharged from the hospital. Overall, the excellent healing response achieved on this 16-year-old chronic wound suggests that the synthetic hybrid-scale fiber matrix may be a good treatment option for difficult-to-heal pressure ulcers.