Management of grade IV decubitus ulcer

We present a case of a female in her 60s with the history of chronic renal failure who presented with a grade IV decubitus ulcer over the sacral region. The ulcer had progressed over several weeks due to prolonged immobility, poor nutritional status, and compromised skin integrity associated with uraemia. Wound debridement, antibiotic therapy, and pressure offloading were initiated alongside renal management. The complexity of care was heightened by impaired wound healing, anaemia, and fluid-electrolyte imbalances. Her dependence on caregiver for activities of daily living such as bathing, feeding, and mobility, impacted both physical and psychosocial well-being. The caregiver faced challenges like maintaining wound hygiene, ensuring adherence to treatment, and managing the emotional toll of progressive deterioration. This case highlights the intricate interplay between chronic disease and decubitus ulcer management, emphasising the need for a multidisciplinary approach that supports both patient and caregiver in improving functional outcomes and quality of life.