Abstract
The promotion of home-based measures against pressure ulcer is a critical issue in recent medical remuneration, and therefore the provision of reliable, safe, and high-quality medical care while maintaining home-based care is required even for patients with refractory pressure ulcer. This study reports 2 patients with pressure ulcer developed after spinal injury. Both cases were refractory, where assessment and treatment of the ulcer on an outpatient basis did not alleviate the condition for several years. Both patients could move into their wheelchair and drive themselves (daily life independency rank B), and thus they were responsible for ulcer care. When the new charge for management of nursing visits to patients under home-based care was introduced, a certified wound, ostomy, and continence nurse visited the 2 patients together with a visiting nurse. Their collaboration resulted in alleviation and healing of the pressure ulcer. This form of care enabled the underlying factors in daily life that delay the healing of these ulcers to be analyzed and identified, which has so far been impossible to do through outpatient treatment.
