J Wound Manag Res.  2021 Feb;17(1):81-84. 10.22467/jwmr.2020.01375.

Closed Irrigation System for Wound Management of Complicated Ischial Pressure Ulcers

• Sung KY
• Lee SY

• KMID: 2513930
• DOI: http://doi.org/10.22467/jwmr.2020.01375

Abstract

In patients with complicated ischial pressure ulcers, surgical repair is often delayed until the general condition of the patient improves, and in extremely ill patients, surgery might never be performed. Since deep ischial ulcers are usually associated with a profuse discharge, large sinus cavity, and are adjacent to the anus, maintaining effective dressing is challenging for surgeons. In order to manage such ischial ulcers, we devised a closed irrigation system using the Barovac (50–90 mmHg) wound drainage device and a saline infusion set. The system was applied to a 50-year-old paraplegic man who was diagnosed with impending sepsis due to a longstanding ischial ulcer with secondary infection. Using the saline infusion set, we infused 200 mL of saline into the ischial cavity every 6 hours in the ward. After a 10-minute dwell time, the fluid in the cavity, including the exudate and wound debris, was drained continuously through the wound drainage device. This system was very helpful in keeping the patient’s ischial wound clean until his general condition improved and surgical repair could be undertaken. We therefore believe that our closed irrigation system provides an effective, convenient, and inexpensive dressing method for patients with complicated ischial wounds.

Keyword

Ischium; Pressure ulcer; Wounds and injuries; Drainage; Suction