Authors (including presenting author) :
Lam CF(1), Cheung YM(2), Kong YW(2), Chan HN(3)
Affiliation :
(1) Department of Surgery, Tung Wah Hospital, (2) Department of Physiotherapy, Tung Wah Hospital, (3) Department of Dietetics, Tung Wah Hospital
Keyword 1: :
Multidisciplinary care
Keyword 2: :
Wound healing
Keyword 3: :
Nutritional support
Keyword 4: :
Magnetopulse
Introduction :
Managing complex wounds in elderly patients with multiple comorbidities requires a coordinated, multidisciplinary approach. This case highlights the collaborative efforts of healthcare professionals to optimize wound healing, nutritional status, and functional outcomes for a bedbound, malnourished patient with a large sacral wound, electrolyte imbalances, and Parkinsonism.
Objectives :
To demonstrate how a structured multidisciplinary approach improved wound healing, reduced infection risk, enhanced mobility, and empowered caregivers in preparation for discharge, aligning with patient-centered care principles.
Methodology :
A multidisciplinary team (MDT) was formed, including wound care specialists, physicians, nurses, dietitians, physiotherapists, occupational therapists, and community nurses. Interventions included:
- Medical team: Corrected nutritional deficiencies (zinc, selenium, iron, Vitamin C), managed antibiotics, and inserted a Foley catheter to prevent wound soiling. - Wound team: Performed conservative sharp debridement and applied advanced negative pressure wound therapy (NPWT) with instillation, silver dressings, and collagen to promote granulation. - Nursing team: Implemented pressure injury prevention measures and educated the patient’s daughter on wound care. - Dietitian: Prescribed a high protein oral supplement enriched with nutrients including arginine, vitamin C, vitamin E, Selenium and zinc to improve patient's nutritional status. - Physiotherapist: Applied magnetopulse therapy to improve circulation and conducted daily passive range of motion exercises to prevent joint contractures and maintain limb mobility. - Occupational therapist: Planned home modifications for safer caregiver assistance.
- Community nurse: Ensured continuity of care post-discharge.
Result & Outcome :
After two months, the wound significantly improved and patient was transitioned to home care successfully: - Reduced dimensions with over 90% granulation tissue - Resolved bone exposure and infection; exudate controlled to moderate levels.
- Maintained joint mobility through physiotherapy interventions. - Caregiver training enabled safe transition home with CNS-assisted dressings.
- Patient’s daughter and wife well satisfied. The MDT’s coordinated efforts enhanced healing, minimized complications, preserved functional mobility, and empowered the family, demonstrating the impact of teamwork on patient-centered outcomes.
