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Thread: pressure sore stage III/IV with deep tunneling

  1. #1

    pressure sore stage III/IV with deep tunneling

    I am looking for some advice on a sore I've been battling for awhile, it's located near my hip on the underside of my thigh. I am currently using a wound vac but am having trouble getting the tunneling to close up. I am currently on the white foam, has anyone been able to get the tunnels to heal by just the vac alone? I'm trying to avoid surgery if at all possible, but the wound is closing on the outside and the tunnels aren't getting any smaller.


    Does anyone know what causes the tunnels?

  2. #2
    Senior Member vgrafen's Avatar
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    You may have osteomyletis. I used the wound vac for 9 months with no results, and have learned that my osteo precludes any healing with the vac. I'm off the vac, my infectious disease doc is packing the wound with sugar, and we're seeing good results.

    You gotta get it checked. Good luck.
    vgrafen

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  3. #3
    Senior Member lynnifer's Avatar
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    Agreed. Tunneling (or fistulas or sinus or whatever you call them) is from infection. What antibiotics are you taking?

    I think the wound vac is contraindicated with infection .. nurse?
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  4. #4
    Hi,

    Yes, I have seen tunneling get better with the vac and it helps if you can get the foam into the tunneled areas but not always possible. Are they making any adjustments in the pressure of the wound vac?

    And yes, if your sore probes to bone or if you have any reason to suspect the sore has penetrated down to bone, most often, antibiotics will be given based on a culture of the bone. Wound vacs can be used with osteomyelitis and I have seen good healing with the vac and antibiotics.

    AAD

  5. #5
    Quote Originally Posted by SCI-Nurse
    Hi,

    Yes, I have seen tunneling get better with the vac and it helps if you can get the foam into the tunneled areas but not always possible. Are they making any adjustments in the pressure of the wound vac?

    And yes, if your sore probes to bone or if you have any reason to suspect the sore has penetrated down to bone, most often, antibiotics will be given based on a culture of the bone. Wound vacs can be used with osteomyelitis and I have seen good healing with the vac and antibiotics.

    AAD
    They have been telling me that it doesn't look infected, and yes it does go down near the bone. The last time the wound was debreeded they did a culture on the tissue and found that the bugs in my wound required some sort of penicillin, which they thought I was alllergic to. This was before the vac so they started using aquacell AG in the wound then eventually I got on the vac after I got out of the hospital from a uti at the same time of the debreeding. I have only been on the vac since the end of June. The wound seems to be closing from the outside leaving the tunnels still in place. We switched to the white foam recently and there having trouble getting the foam into the tunnels now due to the opening getting smaller. The tunnels are 7cm deep and the wound is 3.5cm deep, approx. I am having trouble staying off of it since my right side is starting to hurt from spending so much time on that side.

    I am currently on Amoxicillin, allegedly for my UTI's but I think the wound is whats making me sick but that could be just me being paranoid. I also developed wounds on my butt near the tailbone from being in bed all the time as well. Another stage III which is currently closing up fortunately. I have never seemed to have this much trouble before, but I am 15 years post injury and this is the 1st time I have been hospitalized for anything.

    Thanks SCI nurse, I was just looking for an unbiased opinion since I am having trouble deciding on what to do.

  6. #6
    Senior Member fishin'guy's Avatar
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    Hey team, king of the wound vac guy here!. Had a hole open in my back at surgical site, was undermined 7"up, and 6" down, and to the spine, hole size of a small football.Year and half on vac, had 6 diff. infections during time.(I didn't help matters much by going hunting for deer and elk with the thing on me).So it can be used w/ biotics. Mine wound was so large it stayed open by itself, but lotsa debriding.This was 4 yrs ago, unfortunately I now have same problem-infect has been in back since surgery yr ago-now gonna have to have it opened and cleaned out
    I sure hope yours gets better soon, dam it's tough goin when we're having to sit and layso much. Take care -get better, k?
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