In brief
This 2026 IJSR case report details the successful management of a Grade III sacral pressure injury in an elderly, multimorbid patient using comprehensive evidence-based nursing interventions. Key elements included repositioning, advanced wound care, nutritional optimization (especially glycemic control), skin...
What this article is about
Quick Answer
This 2026 IJSR case report details the successful management of a Grade III sacral pressure injury in an elderly, multimorbid patient using comprehensive evidence-based nursing interventions. Key elements included repositioning, advanced wound care, nutritional optimization (especially glycemic control), skin surveillance, physiotherapy, and caregiver education. The wound size reduced from 20 cm² to 6 cm², and the PUSH score improved significantly, demonstrating effective multidisciplinary care.
Student takeaways
Key Takeaways
- A Grade III sacral pressure injury was successfully managed using a multidisciplinary evidence-based approach.
- Regular repositioning, advanced wound care, nutritional optimization, glycemic control, skin surveillance, physiotherapy, and caregiver education were key components of the intervention.
- The patient's wound size reduced from 20 cm² to 6 cm² over the course of treatment.
- The PUSH score improved significantly from an initial value of 12 (indicating significant tissue loss) to a final value of 6 (suggesting partial thickness skin loss with granulation).
- This case report demonstrates that even severe pressure injuries can improve substantially with dedicated, comprehensive care.
Student summary
Why This Research Matters
This case study, published in the International Journal of Science and Research (IJSR) on June 24, 2026, by Shruti Banduni and Renu Pandey, focuses on a Grade III sacral pressure injury. The authors present a detailed account of its successful management using evidence-based nursing care.
The research problem addressed is the significant patient safety concern posed by pressure injuries, especially in elderly patients with multiple comorbidities like diabetes mellitus, hypertension, chronic kidney disease, cerebrovascular accident, Parkinsonism, and ileocecal tuberculosis. The case study describes a 75-year-old bedridden male patient who developed this severe wound.
The core of the nursing intervention involved a comprehensive, multidisciplinary approach grounded in evidence-based practice. Key components included: 1. Regular repositioning to prevent further pressure on vulnerable areas. 2. Advanced wound care techniques tailored to the Grade III injury. 3. Nutritional optimization to support healing and overall health. 4. Glycemic control, crucial for a patient with diabetes mellitus as uncontrolled blood sugar can impede wound healing. 5. Skin surveillance to monitor progress and detect any complications early. 6. Physiotherapy to improve mobility and circulation where possible. 7. Caregiver education to ensure continuity of care beyond the clinical setting.
For students, it's crucial to appraise several aspects: * **Evidence-Based Practice (EBP):** The case report emphasizes EBP. Students should understand how specific nursing interventions were chosen based on existing research and best practices for pressure injury management. * **Multidisciplinary Care:** The success highlights the importance of collaboration between nurses, physicians, dietitians, physiotherapists, and caregivers in complex patient cases. * **Patient-Specific Factors:** The patient's multiple comorbidities (diabetes, hypertension, CKD, CVA, Parkinsonism) significantly influenced his risk for developing a pressure injury and the complexity of its management. Students should learn how to assess individual patient risks comprehensively. * **Outcome Measurement:** The study used objective measures like wound size reduction (from 20 cm² to 6 cm²) and PUSH score improvement (from 12 to 6). Understanding these metrics is vital for evaluating the effectiveness of interventions.
Regarding source/rights cautions, while the DOI landing page provides a persistent identifier, which aids in citation lookup, it's important to note that this particular record lacks a PMID. This means verification through PubMed might not be possible. The rights status is reported as 'source-linked,' but without further details on open access or copyright, students should exercise caution regarding direct reuse of full text content and always cite the source appropriately.
A nurse would reason from this evidence by recognizing that even severe pressure injuries can improve with dedicated, comprehensive care. This case report serves as a practical example of how to apply EBP principles in real-world scenarios involving complex patients. It reinforces the importance of proactive measures like regular repositioning and diligent skin surveillance for high-risk individuals. Furthermore, it underscores the critical role nurses play not only in direct wound care but also in coordinating multidisciplinary efforts, educating caregivers, and managing comorbidities that impact healing.
The discussion section within the paper notes that this case report has enhanced knowledge and practice in providing evidence-based comprehensive nursing care for pressure injuries. It emphasizes that prompt identification and treatment are essential to prevent worsening of these wounds. This aligns with broader public health goals of improving patient safety and outcomes, particularly among vulnerable elderly populations.
Source abstract
Study Overview
Pressure injuries are a significant patient safety concern, particularly among elderly patients with multiple comorbidities and limited mobility. This case study describes the successful management of a Grade III sacral pressure injury in a 75-year-old bedridden male with diabetes mellitus, hypertension, chronic kidney disease, cerebrovascular accident, Parkinsonism, and ileocecal tuberculosis. A comprehensive evidence-based nursing approach, including regular repositioning, advanced wound care, nutritional optimization, glycemic control, skin surveillance, physiotherapy, and caregiver education, was implemented. Over the course of treatment, the wound size reduced from 20 cm? to 6 cm?, and the PUSH score improved from 12 to 6, demonstrating the effectiveness of multidisciplinary, evidence-based nursing interventions in promoting wound healing and improving patient outcomes. Discussion: The case report has enhanced the knowledge and practice in providing evidence based comprehensive nursing care. The knowledge of pressure injury is essential to act promptly in identifying and treating the worsening of pressure injury.
Evidence appraisal
Main Findings
- A Grade III sacral pressure injury was successfully managed using a multidisciplinary evidence-based approach.
- Regular repositioning, advanced wound care, nutritional optimization, glycemic control, skin surveillance, physiotherapy, and caregiver education were key components of the intervention.
- The patient's wound size reduced from 20 cm² to 6 cm² over the course of treatment.
- The PUSH score improved significantly from an initial value of 12 (indicating significant tissue loss) to a final value of 6 (suggesting partial thickness skin loss with granulation).
- This case report demonstrates that even severe pressure injuries can improve substantially with dedicated, comprehensive care.
Practice transfer
Clinical Relevance
- Nurses should advocate for and implement evidence-based multidisciplinary approaches in managing complex pressure injuries.
- Regular repositioning remains a cornerstone of prevention and treatment for pressure injuries, especially in bedridden patients.
- Comprehensive assessment and management of comorbidities (like diabetes) are critical to optimizing wound healing outcomes.
- Caregiver education is an essential component of long-term care planning for patients with chronic wounds or high risk for them.
- Objective outcome measures like PUSH scores should be used routinely to track progress and evaluate the effectiveness of interventions.
Critical appraisal
Limitations
- As a case report, it describes a single patient's experience and may not be generalizable to all populations or settings.
- The abstract does not provide details on the duration of treatment or specific advanced wound care products used.
- The study type (case report) inherently limits causal inference about the effectiveness of individual interventions within the comprehensive package.
Classroom use
Discussion Questions
- How do you think the patient's multiple comorbidities specifically influenced his risk for developing a Grade III pressure injury and complicated its management?
- Which aspect of the described nursing care intervention (e.g., repositioning, nutrition, glycemic control) do you believe contributed most significantly to the observed healing progress? Why?
- What challenges might arise in implementing such a comprehensive multidisciplinary approach in different healthcare settings or resource-limited environments?
- How can nurses effectively educate caregivers about pressure injury prevention and management for patients with complex needs like this one?
- Beyond direct wound care, what other roles do nurses play in the overall success of managing severe wounds in high-risk individuals?
- What specific advanced wound care techniques might have been employed given it was a Grade III sacral pressure injury? (Note: The abstract doesn't specify)
- How does glycemic control directly impact the healing process of a diabetic patient with a pressure ulcer, and what are common strategies to achieve this?
- Why is skin surveillance particularly important in patients recovering from severe pressure injuries?
- What ethical considerations arise when managing a very elderly patient with multiple comorbidities and a significant wound like this one?
- How can findings from case reports like this be integrated into broader evidence-based guidelines for pressure injury care?
Knowledge check
Quiz
1. What was the initial grade of the pressure injury described in this case report?
- Grade I
- Grade II
- Grade III
- Grade IV
Rationale: The abstract states: 'This case study describes the successful management of a Grade III sacral pressure injury'.
2. Which patient characteristic is NOT mentioned as being present in the 75-year-old male with the pressure injury?
- Diabetes mellitus
- Hypertension
- Chronic kidney disease
- Cerebrovascular accident and Parkinsonism
Rationale: The abstract lists: 'diabetes mellitus, hypertension, chronic kidney disease, cerebrovascular accident, Parkinsonism'. Ileocecal tuberculosis is listed as a keyword but not explicitly stated in the patient's comorbidities.
3. What was the final grade of the pressure injury after treatment?
- Grade I
- Grade II
- Grade III
- No improvement
Rationale: The abstract states: 'the wound size reduced from 20 cm² to 6 cm², and the PUSH score improved from 12 to 6'. The discussion mentions regression to Grade I.
4. Which of the following was NOT part of the comprehensive evidence-based nursing approach implemented?
- Regular repositioning
- Advanced wound care
- Nutritional optimization
- Surgical debridement
Rationale: The abstract lists: 'regular repositioning, advanced wound care, nutritional optimization, glycemic control, skin surveillance, physiotherapy, and caregiver education'.
5. What was the initial PUSH score for the pressure injury?
- 6
- 12
- 18
- 24
Rationale: The abstract states: 'the PUSH score improved from 12 to 6'.
6. Which of these interventions is NOT explicitly mentioned as part of the nursing care in this case report's abstract?
- Glycemic control
- Skin surveillance
- Physiotherapy
- Psychological intervention
Rationale: The abstract lists: 'glycemic control, skin surveillance, physiotherapy'. Psychological intervention is a keyword but not part of the listed nursing interventions.
7. What was the final PUSH score for the pressure injury after treatment?
- 6
- 12
- 9
- 3
Rationale: The abstract states: 'the PUSH score improved from 12 to 6'.
8. Which type of study is this article classified as by its source metadata?
- Randomized Controlled Trial (RCT)
- Systematic Review
- Case Report
- Meta-analysis
Rationale: The 'studyType' field in the source metadata is listed as 'Journal article', and the title explicitly states it's a 'Case Report'.
9. What was the patient's age?
- 65 years old
- 70 years old
- 75 years old
- 80 years old
Rationale: The abstract describes: 'a 75-year-old bedridden male'.
10. Which of these is NOT listed as a keyword for this article?
- medicine
- pressure injury
- nursing interventions classification
- emergency medicine
Rationale: The keywords list includes 'intensive care medicine'. The options provided in the question are: medicine, pressure injury, nursing interventions classification, emergency medicine. Therefore, all these options ARE listed as keywords.
Study cards
Flashcards
What type of study was conducted?
A case report.
Which journal published the article?
International Journal of Science and Research (IJSR).
When was this article published?
2026-06-24.
Who are the authors of the study?
Shruti Banduni and Renu Pandey.
What is the DOI for this paper?
10.21275/sr26620144730.
Which patient characteristic was a significant concern in pressure injury prevention?
Elderly patients with multiple comorbidities and limited mobility.
What grade of pressure injury did the patient initially have?
Grade III sacral pressure injury.
How old was the patient described in this case report?
75 years old.
What is one key factor mentioned for managing pressure injuries effectively?
Regular repositioning.
Which aspect of care was highlighted as crucial alongside advanced wound care and nutritional optimization?
Glycemic control.
What was the initial PUSH score reported in this case report?
12
How did the patient's PUSH score change during treatment?
It improved from 12 to 6.
Which of the following is NOT listed as a comorbidity for the patient? (Options: diabetes mellitus, hypertension, chronic kidney disease, cerebrovascular accident, Parkinsonism, ileocecal tuberculosis)
None of these are explicitly stated as *not* being a comorbidity; all were mentioned.
What was one outcome measure used to assess wound healing?
Wound size reduction (from 20 cm² to 6 cm²).
Which intervention is NOT listed in the comprehensive evidence-based nursing approach described?
Surgery (not explicitly mentioned as part of this specific care plan).
What was a key goal of caregiver education in this case report?
To enhance knowledge and practice in providing evidence-based comprehensive nursing care.
What is one essential action for nurses to take regarding pressure injuries, according to the discussion?
Act promptly in identifying and treating worsening pressure injury.
Which aspect of patient health was targeted by glycemic control interventions?
Diabetes mellitus.
What type of care does 'nursing interventions classification' refer to in this context?
Evidence-based nursing care, specifically the comprehensive approach implemented for wound healing and patient outcomes improvement.
Flashcard 20: How does this study support nursing learning?
It helps students connect medicine with evidence-based clinical reasoning.
Search-ready answers
Frequently asked questions
What was the main focus of this case report?
The main focus was to demonstrate the effectiveness of a comprehensive, evidence-based nursing approach in managing and regressing a Grade III sacral pressure injury to Grade I.
Who were the authors of this study?
The authors are Shruti Banduni and Renu Pandey.
What type of article is this?
This is a case report, which describes an individual patient's experience with medical care.
In what journal was this case report published?
It was published in the International Journal of Science and Research (IJSR).
When was this study published?
The publication date is 2026-06-24.
What were some key nursing interventions mentioned for pressure injury management?
Key nursing interventions included regular repositioning, advanced wound care, nutritional optimization, glycemic control, skin surveillance, physiotherapy, and caregiver education.
How did the size of the pressure injury change during treatment?
The wound size reduced from 20 cm² to 6 cm² over the course of treatment.
What was the improvement in the PUSH score for this patient's pressure injury?
The PUSH score improved from 12 to 6, indicating significant healing progress.
For which specific grade of pressure injury did regression occur?
A Grade III sacral pressure injury regressed to a Grade I.
What is the DOI for this case report?
The DOI (Digital Object Identifier) for this case report is 10.21275/sr26620144730.