Placental allografts for stalled pressure injuries in post-acute care: a case series

Pressure injuries (PI) are among the most common diagnoses in healthcare billing, yet their true prevalence is likely underestimated. Transition from hospital settings to post-acute care (PAC) often reduces access to advanced mobile wound care providers (AMWCP), contributing to stalled healing. Older patients with multiple comorbidities and limited mobility are particularly vulnerable. This research examines the impact of applying placental allografts to stalled PIs to improve wound closure. The practitioners were AMWCP in PAC skilled nursing facilities (SNFs).

This was a case series of patients with stage 3 PIs acquired in hospital settings which failed to close after transferring to a SNF. AMWCP implemented individualised treatment plans addressing nutrition, perfusion and infection control. Standard of care, such as dressing changes, debridement, offloading and compression, was supplemented with placental allografts. Wound size, wound area reduction (WAR), time to closure and recurrence were tracked.

A total of three male patients were included in this case series. All PIs remained stalled for at least four weeks prior to allograft intervention. Wound sizes ranged from 10.9-38.3cm², occurring on the heels or sacrum. Following specialised care and placental allograft application, complete closure (100% WAR) was achieved in all cases within 42 days. No recurrence was observed during follow-up periods.

Placental allografts may provide an effective strategy for closing stalled PIs in older patients, as part of a comprehensive AMWCP personalised patient treatment plan, improving outcomes and quality of life.