Wound care success story: Kaleb’s journey

Kaleb’s journey with Texas Children’s Hospital began even before he was born. Diagnosed with spina bifida during pregnancy, his mom, Paola, was referred to Texas Children’s Pavilion for Women for specialized maternal-fetal care. Kaleb underwent his first surgery shortly after birth, and Texas Children’s has been like a second home ever since to help with treatment for spina bifida and related conditions.

“He’s been through so much, but Texas Children’s has always been there for us,” said Paola. “We know he’s in good hands.”

Now 11 years old, Kaleb is full of curiosity. He loves reading, especially when it involves superheroes like Captain America. He’s part of a book club and enjoys studying science — his favorite subject. 

A complicated challenge

About 2 years ago, Kaleb developed a serious pressure injury. These types of wounds happen when there’s too much pressure on certain parts of the body — usually over bones like the hips or lower back. Kids who use wheelchairs, like Kaleb, are more at risk because they sit for long periods of time.

Because of nerve damage from his spina bifida, Kaleb couldn’t feel the pain from the injury. But even without pain, pressure injuries are dangerous because they can easily become infected.

These wounds don’t always heal in a straightforward way. They may get better for a while, then worsen again — especially if a child is dealing with other health issues. That’s exactly what happened with Kaleb. His wound improved with treatment, but every time he was hospitalized for other spina bifida-related problems, the pressure injury would worsen.

It was a challenging cycle — one that required Texas Children’s Wound Care team to take a holistic approach. They looked at everything — his mattress, nutrition, medical conditions and more — to figure out what was making the wound worse. Then they used advanced tools and treatments to target the root causes and help keep it from coming back.

Key technology: Pressure mapping

The team used pressure mapping, a specialized tool that displays pressure points on Kaleb’s wheelchair, to identify where his weight was distributed. This tool helps the team identify where cushioning is needed to relieve pressure. Adjustments were made to his wheelchair to distribute weight more evenly, a crucial step since wheelchairs for children typically are only approved for replacement every 5 years, despite the way continued growth changes weight distribution and cushioning needs. 

Paola shared how much this approach helped: “Once we started working with Wound Care, everything started to improve immediately.”

The power of a team

Texas Children’s Wound Care Clinic, led by Ryan Krasnosky, MPAS, PA-C, DrPH, Division Chief of Pediatric Wound Care, stands out for its multidisciplinary approach. Depending on a child’s specific needs, specialists from infectious disease, orthopedics and nutrition work together to treat complex wounds like Kaleb’s. For his family, the support extends beyond medical expertise. The team’s wound care coordinators and nurses partner with families to help them access resources and teach them how to do wound dressings and troubleshoot symptoms they may see at home. In other cases, they work directly with insurance companies to get supplies shipped directly to families — often at no cost.

“Kaleb loves coming to see Dr. Ryan,” Paola said. “He even does drawings for him. Dr. Ryan takes the time to learn about his patients, and Kaleb appreciates that he’s given a voice during appointments. It gives him hope and motivation.”

Texas Children’s Wound Care team also offers yearly wheelchair evaluations and sees families at community locations across the area. This makes it easier for families like Kaleb’s to get the care they need without a long drive to the Texas Medical Center.

Healing and hope

Kaleb’s wound is now almost fully healed. What began as a stubborn injury is now a nearly resolved issue, thanks to careful monitoring, wheelchair adjustments and nutritional support. Kaleb continues to thrive — when he’s not diving into his favorite Marvel movies, he’s playing Minecraft or spending time outdoors.

Paola has one piece of advice for other parents: “Always ask questions and advocate for your child. Texas Children’s is wonderful — be open to trying new options.”

Her gratitude for the care her son received is clear. “Thank you for your dedication. It’s people like you that make us want to come back.”

A brighter future

Kaleb’s story is just one example of how Texas Children’s provides compassionate, expert care for kids with complex needs. Through teamwork, innovative technology and personalized attention, families can find hope and healing right where they need it — close to home.