(CS-137) Enhancing Healing Trajectories in Pressure Injuries Through Targeted Desloughing and Antimicrobial Control

Abigail Chaffin, MD, FACS, CWSP, MAPWCA; Rachel Garner, BS; Ross Jacobson, MBA; James Pai, MS

Introduction: Pressure injuries remain a significant challenge in the wound care setting, particularly among patients with reduced mobility or chronic illness. Suboptimal management, including ineffective dressing selection, can delay healing, increase infection risk, and allow progression to higher-stage wounds. Highly charged fiber dressings impregnated with silver provide continuous desloughing action and antimicrobial control, offering a promising option for chronic wounds at risk for or showing signs of infection. Evidence suggests these dressings can reduce exudate and slough burden while promoting granulation tissue formation in chronic wounds and pressure ulcers^1-3. This case series underscores the importance of appropriate dressing selection in pressure injury care and highlights the benefits of highly charged fiber dressings in nonoperative management.

Methods: We present two nonoperative patients with advanced pressure injuries treated using highly charged fiber dressings as the primary therapy. Cases include a 73-year-old female with a stage IV buttock pressure injury and a 64-year-old male with a postoperative pressure wound near the ischium following prolonged immobilization. Dressings were applied per manufacturer guidelines and changed 2–3 times weekly. Wound progression was assessed through serial photographic documentation, slough burden evaluation, wound measurements, infection surveillance, and periwound assessment. A multidisciplinary approach incorporating offloading, nutritional optimization, coordinated wound care, and comorbidity management supported overall healing.

Results:

Both wounds demonstrated marked improvement in wound bed quality following initiation of highly charged fiber dressings. Each case showed visible reduction in slough, enhanced granulation tissue formation, and decreased odor and drainage within the early weeks of therapy. The dressing was well tolerated, with no increase in pain or wound bed maceration. Both patients exhibited favorable healing trajectories and avoided the need for operative debridement.

Discussion: Highly charged fiber dressings offer dual benefits through gentle autolytic desloughing and antimicrobial activity, helping establish an optimal wound environment for tissue repair in contaminated or infection-prone pressure injuries. Current evidence supports their use to reduce infection risk and enhance wound progression, particularly in patients who are not candidates for surgery. Findings from this case series reinforce the value of these dressings as an important component of multidisciplinary nonoperative pressure injury management.