Non-healing wound in senior patient

Abstract

Aim: To present a senior patient with impaired wound healing ability. A 65-year-old female presented with a non-healing wound on the left calf. 6 weeks before the presentation the patient was injured by a cow at her home. Lacerated wound on the left calf, with skin defect size of 7 x 6 cm. covered with the granulation tissue. Area slightly oedemic. Blood culture revealed very large growth of S. Aureus and β-haemolytic streptococci - susceptible to penicillin and oxacillin. Method: Immediately after hospitalization, patient underwent autodermoplasty operation. Wound was washed with antiseptic solutions beforehand. Split-thickness skin graft was harvested from the left shin to completely cover the skin defect. Staples were used for the fixation. Patient continuously received antimicrobial agent therapy based on microbiology laboratory results. She was discharged on the eighth hospital day with the recommendation to continue applying dressings with chloramphenicol for a few days. Results / Discussion: Patient's wound healing process was impaired primarily by an infection obtained most likely in non-hospital environment. Hospital-acquired infection is unlikely, because of bacteria high susceptibility to antimicrobial agents. Conclusion: It is important to identify the underlying cause of impaired healing of the wound and deal with it. It becomes even harder task in senior patients.