Ghidinelli Federico, Zanolini Gabriele, Minoretti Piercarlo
Geriatrics, Agenzia di Tutela della Salute, Brescia, ITA.
General Medicine, Azienda Socio-Sanitaria Territoriale della Franciacorta, Chiari, ITA.
Cureus. 2025 Jul 7;17(7):e87421. doi: 10.7759/cureus.87421. eCollection 2025 Jul.
Pressure ulcers, particularly among elderly patients with acute medical conditions, represent a significant clinical challenge and are associated with substantial morbidity and healthcare resource utilization. Autophagy, a fundamental cellular pathway involved in protein and organelle degradation, has emerged as a critical regulator of tissue repair and wound healing by orchestrating inflammatory cell activation, extracellular matrix deposition, and keratinocyte proliferation and differentiation. Topical application of magnetized saline water (MSW) may increase the expression of autophagy biomarkers in skin tissue, representing a potentially efficacious management strategy for wound care. We conducted a prospective observational case series to explore the clinical utility of a topical hydrogel containing 95% MSW in the management of stage 2‒3 pressure ulcers in elderly patients admitted to an acute medical unit. Five geriatric inpatients (age range: 75-93 years) who developed hospital-acquired pressure ulcers during acute care hospitalization were included in the study. Following standard wound cleaning protocols, the topical MSW hydrogel was applied daily to the affected areas. Wound healing progression was monitored via clinical photography, assessment of granulation tissue formation, and documentation of any adverse events. All patients exhibited effective wound healing, with clear clinical improvement observed as early as three days and up to 10 days following initiation of hydrogel application. Notable findings included granulation tissue formation, enhanced wound bed vascularization, progressive wound margin contraction, and active epithelial advancement. Intriguingly, these favorable outcomes were achieved despite the presence of severe comorbidities, including acute heart failure, pneumonia, and multi-organ dysfunction, which are typically associated with impaired wound healing in the elderly population. No adverse reactions related to the hydrogel application were evident. In summary, the findings from this case series suggest that an MSW-based hydrogel capable of stimulating autophagy may represent a promising therapeutic strategy for the management of pressure ulcers in acutely ill elderly patients. Further controlled studies are warranted to confirm these preliminary observations and to establish the role of MSW-based preparations within the broader context of wound care in geriatric medicine.
压疮，尤其是在患有急性疾病的老年患者中，是一项重大的临床挑战，并且与显著的发病率和医疗资源利用相关。自噬是一种参与蛋白质和细胞器降解的基本细胞途径，通过协调炎症细胞激活、细胞外基质沉积以及角质形成细胞增殖和分化，已成为组织修复和伤口愈合的关键调节因子。局部应用磁化盐水（MSW）可能会增加皮肤组织中自噬生物标志物的表达，这代表了一种潜在有效的伤口护理管理策略。我们进行了一项前瞻性观察性病例系列研究，以探讨一种含有95% MSW的局部水凝胶在急性内科病房老年患者2-3期压疮管理中的临床效用。该研究纳入了五名老年住院患者（年龄范围：75-93岁），他们在急性护理住院期间发生了医院获得性压疮。按照标准伤口清洁方案，每天将局部MSW水凝胶应用于受影响区域。通过临床摄影、评估肉芽组织形成以及记录任何不良事件来监测伤口愈合进展。所有患者均表现出有效的伤口愈合，早在应用水凝胶后三天至十天就观察到明显的临床改善。显著发现包括肉芽组织形成、伤口床血管化增强、伤口边缘逐渐收缩以及活跃的上皮推进。有趣的是，尽管存在严重的合并症，包括急性心力衰竭、肺炎和多器官功能障碍，而这些通常与老年人群伤口愈合受损相关，但仍取得了这些良好结果。未发现与水凝胶应用相关的不良反应。总之，该病例系列的结果表明，一种能够刺激自噬的基于MSW的水凝胶可能是急性病老年患者压疮管理的一种有前景的治疗策略。需要进一步的对照研究来证实这些初步观察结果，并在老年医学伤口护理的更广泛背景下确定基于MSW的制剂的作用。
