Patient Overview
A 59-year-old African American male with seizure disorder, osteomyelitis, leukocytosis, and protein-calorie malnutrition presented for wound care evaluation.
Presentation
The patient had a chronic, non-healing Stage 4 sacral pressure injury that began in April 2025. At evaluation, the wound had persisted for 7 weeks.
Failed Standard of Care
Initial management included selective sharp debridements, medihoney, calcium alginate, and bordered foam dressing. After more than four weeks without improvement, the clinical team determined the patient was suitable for advanced therapy with DermaBind full-thickness placental membrane.
Treatment Protocol
Providers cleansed the wound thoroughly, applied full-thickness DermaBind placental membrane allograft with complete tissue contact, covered it with a silicone contact layer, and secured it with steri-strips and Xeroform. A bordered foam dressing protected the site. Average visit intervals were 8 days.
Outcomes
The patient received seven DermaBind applications at weekly appointments. At week eight, providers discontinued the graft and transitioned to standard care (medihoney and bordered foam dressing). By week eleven, the wound achieved 100% re-epithelialization. The wound demonstrated a 91.4% surface area reduction during the DermaBind treatment period.
Clinical Significance
This case demonstrates responsible utilization of advanced biologics by discontinuing treatment when no longer clinically necessary, avoiding over-use of skin substitutes while maintaining evidence-based care.
Provider: Oludayo Toby Ojelade, NP
