Introduction
The patient is a 75 year-old female with a history of bowel cancer. In 2002, she underwent ostomy surgery. During this hospitalization, the patient developed a full thickness pressure ulcer that led to necrotizing fasciitis of the sacrum and buttocks. As a result, the patient underwent extensive surgery to remove the infected tissue. Post-surgically the wound was successfully treated with negative pressure wound therapy, and a split skin graft was applied to cover the exposed area.
Two years later, a small area of the graft site broke down and an ulcer developed. The ulcer was treated with a variety of dressings, including antimicrobials (iodine, honey and silver), alginates and foams, which would often irritate the skin around the wound. Despite these efforts, there was minimal progression in healing and the wound became static, and the patient had resigned herself to the fact that the wound may never heal. The wound was managed conservatively with a non-adherent wound dressing secured with small amounts of tape so as not to further irritate the skin, with dressing changes on alternate days.