Keywords
Crohn’s Disease
Vulvoperineal Wound
Wound Care Nursing
Advanced Dressing
Case Report
How to Cite
Abstract
Introduction. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that may lead to recurrent abscesses, sinus tracts, scarring, and complex wounds in anatomically and functionally challenging areas. Vulvoperineal involvement may be particularly difficult to manage because of severe pain, high exudate, risk of contamination, and major impact on quality of life.
Case presentation. We report the case of a 38-year-old woman with hidradenitis suppurativa, Crohn’s disease, insulin-dependent diabetes mellitus, and rheumatoid arthritis, who presented with a complex post-surgical vulvoperineal wound following drainage of purulent fistulas. At initial assessment, the wound was deeply cavitated, highly exudative, fibrinous, painful, and at high risk of local infection. Pain during wound care was severe Visual Analog Scale (VAS 8/10), and the patient showed marked psychological distress.
Intervention and Management. A personalized multidisciplinary management plan was established, including multimodal analgesic support, wound cleansing with saline solution and PHMB-based antiseptics, application of an oxygen-enriched oleic matrix dressing, atraumatic secondary dressings, urinary catheter placement to reduce local contamination, and shared hospital-home follow-up. Nursing management focused on pain control, atraumatic local care, infection prevention, patient education, and continuity of care.
Results. Progressive wound improvement was observed over time, with reduction in pain, exudate, fibrin burden, and wound size. After 3 weeks, the wound area was significantly reduced, and complete healing was achieved within 3 months. Treatment tolerance progressively improved, allowing regular outpatient and home-based wound care.
Conclusion. This case highlights the clinical value of individualized nursing management within a multidisciplinary pathway for complex vulvoperineal wounds in patients with HS and multiple comorbidities. Pain control, atraumatic dressing strategies, and continuity of care were key elements in supporting wound healing and treatment adherence.
References
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