Pressure ulcer healing by daily topical sucralfate and silver sulfadiazine: A case report study

Pressure ulcers are localized damage to the skin and/or underlying tissue that usually occurs over a bony prominence as a result of pressure. The patient was a 60‑year‑old male who was admitted to the intensive care unit for 1 month due to decreased consciousness in February 2019. He had a Grade 4 pressure ulcer in the sacrum area measuring 15 cm × 15 cm with 4 cm deep and exudate secretion and discoloration of the ulcer to yellow (ancestral tissue) and necrotic tissue around the ulcer. The ulcer was first bandaged with the daily silver sulfate ointment, but no healing process was achieved. After the patient was conscious and transferred to the inpatient ward, the necrotic tissue was debrided and washed with normal saline every day. Then, the ulcer was coated with 2 g of sucralfate tablets (4 tablets of 500 mg) dissolved in 5 cc of distilled water and mixed with 15 g of silver sulfadiazine ointment and was finally bandaged with sterile gauze. The Pressure Ulcer Scale for Healing instrument was used to evaluate the ulcer healing process. After 40 days, the patient’s ulcer changed to a Grade 2 pressure ulcer measuring about 5 cm × 5 cm with pink color (granular tissue enclosed by epithelial tissue) on the skin.