Effective and hygienic fecal management

J. Sanchez, Stellvertretende Pflegedienstleitung, Pflegezeit Intensiv GmbH Mainz (GER)

Abstract
This case report concerns a 61-year-old, multimorbid, obese, immobile patient with a sacral pressure ulcer, for whose healing the innovative hygh-tec® basic-plus fecal drainage system was successfully applied for more than eight months. The controlled, continuous fecal management not only relieved the wound situation but also enabled the wound healing process. No perianal ulcers or anal lesions were observed during the course of treatment. This case demonstrates that optimal fecal management is essential for the healing of a sacral pressure ulcer in patients with concomitant fecal incontinence.

Course

Observation period: July 7, 2021 – March 22, 2022

• Situation upon admission from the hospital to the intensive care ventilatory unit: The patient arrived with an established hygh-tec® basic-plus fecal drainage system. Due to the pressure ulcer (Fig. 1) and concomitant fecal incontinence, it was decided to continue using the drainage to relieve the wound situation

• Rehospitalization from 27.07.2021 to 03.08.2021, followed by a worsening of the wound situation.

• Frequency of stool leakage: maximum of 2-3 nursing shifts throughout the entire course (> 8 months).

• No perianal ulcers or anal lesions during the observation period.

• The healing of the pressure ulcer was completed on February 14, 2022 (Fig. 2).
  
  

  Fig. 1: Transfer from the hospital (July 7, 2021)

   

  
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J. Weigand, Head of Nurse, Ambulatory Intensive Care, Nursing Service Nightingale Ortenburg (GER)

Abstract
This case report describes a 78-year-old, immobile, awake, and oriented patient with sacral pressure ulcers who was successfully treated over eight months using the hygh-tec fecal drainage system. Due to an incomplete spinal cord injury following polytrauma, the patient was ventilated and suffered from fecal incontinence. The controlled, continuous stool diversion provided effective relief for the wound situation and led to a significant improvement in wound healing. Throughout the entire period of use, no stool leakage, perianal ulcers, or anal lesions were observed. The case emphasizes how crucial dense and long-term stool diversion is for the healing of sacral pressure ulcers in the presence of concurrent incontinence.
The long-term application of the hygh-tec fecal drainage system played a decisive role in stabilizing the wound situation without causing complications, confirming the system’s high tolerability and effectiveness in long-term use.

Course

Observation period: February 19, 2024 – October 19, 2024

• Admission from hospital to intensive care ventilation unit with a 6 x 3.5 cm necrotic pressure ulcer near the perianal area

• Treatment with hygh-tec fecal drainage, supported by Marcogol and Laxoberal to maintain stool flow

• Additional measures: alternating pressure system, targeted positioning concept, wound management, and nutritional therapy

• Two hospital stays:

  • Stay 1: short-term switch to silicone drainage, return to hygh-tec after 7 days, slight deterioration of skin condition

  • Stay 2: inpatient fluid regulation due to febrile infection, hygh-tec remained in use, skin condition unchangedt

• Results: significant reduction in wound size and improvement in granulation
  
  

Fig. 1: Condition after transfer from hospital (Februar 19, 2024)								Fig. 2: Wound significantly reduced, clean wound edges (Oktober 19, 2024)

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