Progressive Mobility to Promote Healing of a Chronic Sacral Wound
This case study, published in the Journal of Wound, Ostomy, and Continence Nursing (March 2025), highlights a collaborative approach to enhancing mobility in a patient with a stage 4 sacral pressure injury, demonstrating that structured out-of-bed sitting can support—not hinder—wound healing.
Case Summary:
- Patient Background: Ms. B, a 49-year-old obese woman, was admitted with a chronic, worsening stage 4 sacral wound. Her mobility was limited due to respiratory issues and pain, which impaired her ability to adhere to repositioning guidelines.
- Intervention Strategy: A physical therapist designed a tailored sitting program that included transfer methods, surface selection, and weight-shifting instructions. This plan was implemented alongside a certified wound care nurse who managed the wound, adjusted sitting duration, and addressed factors like nutrition.
- Outcomes: Ms. B gradually increased her out-of-bed time, ultimately reaching a goal of sitting in her wheelchair for at least 4 hours daily. The wound volume decreased by 92% by discharge.
- Clinical Insight: The case demonstrates how interdisciplinary coordination and patient-centered mobility plans can promote healing of advanced pressure injuries, even when mobility poses an initial risk.
This case reinforces the value of individualized progressive mobility programs as part of comprehensive pressure injury management in complex inpatient settings.
Keywords:
Melissa Delvecchio,
Jacob Knarr,
progressive mobility,
pressure injury,
stage 4 wound,
physical therapy,
WOC nursing,
seating systems