What you have described is possibly a Grade II or III bedsore
(advanced). I would advice you not to use betadine
as this inhibits healing. Hydroheal AM is good but it should not come in contact with saline as it loses its efficiency then. You have not mentioned the culture organism but I can tell you that the role of systemic antibiotics is quite limited in this stage. Turn her every 2 hr or so and take adequate care that moisture does not accumulate under her bed sheet. Also, apply powder to the surrounding skin. If possible, use a pressure relief mattress which expedites healing. However, if the bed sore
is pretty deep then surgical intervention might be the only way to cover the defect therefore you need to talk to a plastic surgeon regarding that.