title: Successful treatment of non-healing pressure ulcers with topical n-acetyl cysteine.
abstract: OBJECTIVE
  N-acetyl cysteine (NAC) is a thiol compound with antioxidant and vasodilatory properties. It has multiple potential uses-including as an aid to wound healing-supported by varying levels of evidence. Pressure ulcers (PUs) are a major problem affecting older and bed-bound patients, and are associated with significant morbidity, mortality, and health-care costs. We aimed to study whether topical NAC treatment may be useful in non-healing PUs in a prospective case study in two debilitated nursing home residents suffering from a total of three treatment-resistant PUs.
  
  
  METHODS
  PUs were staged as described by the National Pressure Ulcer Advisory Panel. The ulcers were measured at the beginning and weekly thereafter with a standard wound measuring paper ruler.
  
  
  RESULTS
  The first patient had a category 3 pressure ulcer and the second patient had one category 3 and one category 4 ulcer. Topical NAC vial administration significantly improved healing in all three PUs without any side effects.
  
  
  CONCLUSIONS
  Our data indicate that NAC may be used in treatment-resistant PUs successfully.
authors.affiliation: Family Physician Specialist, Family Physician, Nurse, Istanbul Metropolitan Municipality, Department of Health and Social Services, Kayisdagi Darulaceze Ministry, Kayisdagi, Atasehir, Istanbul, 34755, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Ozkaya
authors.affiliation: Associate Professor, Internal Medicine, Geriatrics, Internal Medicine, Geriatrics, Professor, Internal Medicine, Geriatrics, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Capa, Fatih, Istanbul, 34390, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Bahat
authors.affiliation: Associate Professor, Internal Medicine, Geriatrics, Internal Medicine, Geriatrics, Professor, Internal Medicine, Geriatrics, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Capa, Fatih, Istanbul, 34390, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Tufan
authors.affiliation: Family Physician Specialist, Family Physician, Nurse, Istanbul Metropolitan Municipality, Department of Health and Social Services, Kayisdagi Darulaceze Ministry, Kayisdagi, Atasehir, Istanbul, 34755, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Dogan
authors.affiliation: Family Physician Specialist, Family Physician, Nurse, Istanbul Metropolitan Municipality, Department of Health and Social Services, Kayisdagi Darulaceze Ministry, Kayisdagi, Atasehir, Istanbul, 34755, Turkey.
authors.forename: Z
authors.initials: Z
authors.lastname: Bilicen
authors.affiliation: Associate Professor, Internal Medicine, Geriatrics, Internal Medicine, Geriatrics, Professor, Internal Medicine, Geriatrics, Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Capa, Fatih, Istanbul, 34390, Turkey.
authors.forename: M A
authors.initials: MA
authors.lastname: Karan
mesh_terms: D000287:Administration, Topical; D000369:Aged, 80 and over; D000975:Antioxidants / Q000627:therapeutic use*; D003545:Cysteine / Q000627:therapeutic use*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D009735:Nursing Homes; D003668:Pressure Ulcer / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000975:Antioxidants; D014665:Vasodilator Agents; D003545:Cysteine
keywords: n-acetyl cysteine; non-healing; nursing home; pressure ulcer; treatment