Pressure Ulcer Associated with Critical Colonization Successfully Treated by Transient Usage of Cadexomer-Iodine: A Case Report

A 56-year-old Japanese man hospitalized for schizophrenia and depression developed pressure ulcer on his greater trochanter due to a long-term bed rest. In spite of applying 0.003% alprostadil alfadex ointment for two months, the ulcer was not improved. Because there was some purulent discharge, we examined semi-quantitative swab bacterial culture from the ulcer and subsequently detected quadrant III of bacteria. Then, 0.9% cadexomer-iodine ointment was applied once a day, resulting in decrease of the discharge and only quadrant I of bacteria culture. Thereafter, by application of polyurethane foams for two months, the wound was completely epithelized. The remarkable acceleration of wound healing after using cadexomer-iodine ointment suggested the initial critical colonization, which might have caused delayed healing.