Mrs. Tan is an 82 y/o lady with left sided hemiplegia, secondary to a right sided Cerebral Vascular Accident (CVA). She is responsive to her name but does not initiate conversation. Since her CVA, she has been confined to bed and has been unable to reposition herself. During the acute phase of her illness she was positioned supine for extended periods. She has some difficulty swallowing.

Her discharge summary notes indicate that she had an open wound over the coccyx, extending through the dermis and subcutaneous tissue, exposing the deep fascia. A small area of adherent necrotic tissue covered the floor of the wound and the sides were diffusely covered with granulation tissue. Mrs. Tan shows no signs of pain at the ulcer site.