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Thread: Please any help with this....

  1. #11
    Senior Member CapnGimp's Avatar
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    OSTEOMYELITIS, infection of the bone. I had this for almost 4 years and my general practice doctor did not diagnose it. 3 failed surgeries because of it and still had the wound. Had it sewn up while taking intravenous antibiotics for a week before and a couple weeks after. I've had no problems since.

    What type of cushion does he use?
    I was sitting/living normally after my surgery using a ROHO 2 chamber cushion. I also was on a Vegan diet, and exercising these four years.

    Diet and exercise are VERY IMPORTANT along with NO smoking, either by him or anyone in the household.

    http://sci.rutgers.edu/forum/showthr...ight=wound+vac

    This was my story...

  2. #12
    Hello friends, I have some updates , after asking to my uncle. (please sorry for my english)
    I will comment the suggestions made by RIchard:
    1. My uncle was treated by a surgeon specialized in reconstructive surgery, but I dont know if they are specialized in pressure ulcers due to SCI. I think there is no one specialized in that specific. Or it would be sufficient being surgeons specialized in reconstructive surgery??
    2. I know the doctors see my uncle 5 weeks after surgery, see the area and tell him if he can start sitting, so he start sitting 15 minutes, but after 2 days he starts feeling the area hot. My question is, after how many weeks normally that wounds are ok so he can start sitting. Maybe he need to wait for a long time.
    3. He wasn´t using a special cushion when he started to sit, he has one (I dont know if it is ok) , but don´t use it because he thinks is very tall for his wheelchair, I dont know if it is not the right cushion or we need to look for another wheelchair.
    Can anyone tell me where can I buy the roho cushion since I`m in Peru ? and which one do you suggest me?
    4. I read about myocutaneous flap procedure and I know doctors wanted to make that but said my uncle doesnt have enough muscle in leg or another part of the body since my uncle is thin, so I don´t know exactly what kind of surgery they made, they said they made a "colgajo"
    5. CapnGimp, about your post:before this last surgery doctors found an infection in the bone, and they said it was little, so they gave him some antibiotics, but only before the surgery I think, but although that the wound continue inside, after an ecography made yesterday doctors say there is a kind of liquid there, so it indicates the surgery need to be done again. Do you know if that is ok??? or there is another way to get the wound healed without a new surgery????

    6. If anyone has a diet to follow to get my uncle in better way I will appreciate it.
    7. What kind of exercise can he do being prostrated? what do you recommend him to do in this condition to avoid boring.

    8. Any advice anyone can give me will be very very appreciated!!


    Mari

  3. #13
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    Hi, Maria, I am new on this forum but I have done a lot of research since my brother was injured two years ago. If there aren't many resources in Peru, maybe you should try Brazil. I hear there are some excellent surgeons and SCI clinics in Brazil. I don't now how far it is from you, but try Flourianopolis. There are some really intriguing things going on there... Best Wishes!

  4. #14

    Post

    Maria -

    I hope that a SCI-nurse will chime in with more expert information than I can give.

    I think that CapnGimp is correct about the bone infection. My thoughts are that the area needs aggressive treatment with antibiotics for some time after it is cleaned out surgically. I presume that a white blood cell count would show when the infection has been conquered and antibiotics can be discontinued (nurse?).

    Having never dealt with a bad pressure sore, I can't give advice on how long it takes to heal, but my thought is that it takes much longer than one would expect based on our "normal" experience of healing, and long after it looks OK on the surface.

    The high profile Roho cushion (which, especially since your uncle is thin, I would think is most appropriate) is about 10 cm high, and is filled with air. My wife uses their Quadtro Select cushion.
    The cushion needs to be the correct size for his chair. The cushion must also be inflated correctly and checked often, as severe damage can occur if it deflates.

    A search of the Roho web site at www.therohogroup.com found this distributor of Roho cushions in Lima:
    Ortopedia Salvador E.I.R. Ltda.
    Av. Militar 2488 Lince
    Lima
    phone 51 14 4199750
    ortosalva@peru.com
    Best wishes,
    Richard

  5. #15
    Maria-
    I echo much of the advice that has already been given. But, here is some additional advice....

    1. The surgeons should do a bone biopsy to determine if your uncle has osteomyelitis. (Infection in the bone) If he does, he needs to go on IV antibiotics for 6 weeks. We never do any surgery until that is cleared up.
    2. 5 weeks after surgery is probably too early for your uncle to start sitting, especially since he does not have a special cushion and has had problems in the past. I would recommend at least 6 weeks of not sitting, but possibly even more. That is usually determined after physical examination of the wound.
    3. When he starts to sit, make sure that the cushion (whichever one he is using) is being used properly. He needs to have a cushion and he needs to do weight shifts at least every 20-30 minutes.
    4. When he starts sitting - start with 15 minutes once a day. If the area gets red or dark and it doesn't disappear within 30 minutes once he lies down, he needs to wait another couple of days. He really needs to take his time on sitting. He should increase his sitting, first by the number of times per day that he sits (for example, 1 15 minute session, then 2, then 3 per day.) Once he gets to 4 times a day, he can increase the time by 15 minutes, then the same routine as above.
    5. As far as diet goes, one high in protein and high in calories is recommended. He may want to try to eat 5-6 small meals a day. The number of calories it takes to heal a wound is huge! Also, he needs to drink plenty of fluids.... 2-3 liters a day.
    6. Rest is also important. Taking naps during the day will not hurt him.

    I am not sure if I answered everything, but please feel free to post again and I will try to clarify anything you need me to.

    Best of luck!

    CKF

  6. #16
    Thank you so much for all the answers. They definitely will help us. I will continue posting until I see my uncle recovered, so I will need from your so appreciated help.

    Thanks again!

    Mari

  7. #17
    Thank you Richard, I`m taking note of the contact.
    Sorry, If I have any doubt I will ask you anything else.

    Mari

  8. #18
    Hello, thanks again for the answers. SCI nurse I have a question, my uncle says that after last surgery he sit up after 7 weeks and started to feel hot that area so he stopped sitting. After that he went to take an ecography and told them there was some liquid inside so doctors take out that liquid. Days after he stopped feeling the area hot and started to sit again for a few minutes and yesterday he was hospitalized again to be examined and see if the liquid inside continues. My question is if maybe his recovery started since he doesn´t feel that area hot and doesn´t see the area red, or although those signs the infection could continue inside and doctors should do another surgery.

  9. #19
    I forgot to tell that after examination doctors said my uncle hasn´t osteomelytis.

  10. #20
    Hello fillygirl thanks for your concern, I received a message from you but I don´t find it now. I will try to update you with my uncle progress.

    Mari

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