Introduction

Pressure injuries are a substantial source of morbidity, particularly among medically complex patients. Healing depends on appropriate local wound management as well as systemic factors such as inflammation, nutritional status, mobility, and infection [1-4]. Although evidence-based inpatient care can promote improvement, maintaining that progress after discharge often depends on whether the patient can continue the treatment plan in the outpatient setting.

Crohn's disease creates additional challenges for wound healing through chronic inflammation, fistulizing disease, recurrent infection, prior intestinal surgery, and nutritional deficiencies [5-10]. Social risks may compound this vulnerability by making an otherwise appropriate outpatient treatment plan difficult to implement [3,11-15].

We present the inpatient course of a patient with advanced fistulizing Crohn’s disease and a recurrent stage 3 sacral pressure injury. This report focuses on wound management during hospitalization and the discharge-planning challenges associated with housing instability. The patient remained hospitalized at the time of writing, and post-discharge continuity of wound care and wound outcomes were therefore not assessed.