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Five pressure ulcers (stage III and stage IV) were successfully treated with collagen sponges filled with gentamicin.All ulcers occurred in an immobile 94-year-old woman with advanced dementia. One of the pressure ulcers, located on the patient's sacrum, was considered life-threatening due to size and depth. All ulcers were treated with a collagen sponge filled with gentamicin; the sponge was replaced at variable intervals, ranging from 6 days to 2 months, depending on absorption of the collagen. All 5 pressure ulcers improved based on reductions in wound depth and surface area. Two of the pressure ulcers healed completely; in these wounds, gentamicin sponge therapy was initiated shortly after development of the ulcer. None of the wounds exhibited evidence of reinfection following initiation of therapy. No adverse events were observed. The rate at which the collagen sponge was absorbed slowed significantly after the initial treatment phase.In this patient, the use of a collagen sponge filled with gentamicin was effective in preventing infection and promoting healing of multiple full-thickness pressure ulcers. Long-term use was not associated with any adverse effects, even in this frail and immobile patient.