Debridement

caSe 2

 - PreSSure ulcer

A 56 year-old female with a history of abdominal compartment syndrome, cirrhosis of the 

liver, acute pancreatitis, congestive heart failure, malnutrition and hepatic encephalopathy, 

developed a sacral pressure ulcer after an episode of ischemia.  Initially the ulcer 

presented as deep tissue injury which then evolved to a stage IV pressure ulcer.  The 

patient was not a candidate for surgical debridement and progress with alternative 

debridement methods was slow. On 4/10/2009 ALH paste was initiated, and covered with 

an absorbent calcium alginate dressing daily. Minimal sharp debridement was performed 

as needed to remove loosened necrotic slough tissue.  Complete healing was achieved 

with only small scab by 8/10/2009.