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Thread: stage 4 pressure sore getting worse

  1. #1

    stage 4 pressure sore getting worse

    so ive had a stage 4 pressure sore for about 6 months ever since i found out i had osteo in my pelvis and myositus in both thighs and pelvic muscle. the sore was healing really well but while i was hospitalized for the infections (which were really bad) the sore got worse. when all the necrotic tissue finally came out about 2 months ago we realized there was severe undermining. i started in on VAC therepy about 6 weeks ago and while some of the undermining got better, places that had none are now severe. in addition to the undermining ive developed tunneling. the places that are getting worse are also the spots i relieve the most pressure off of so i dont understand how they can get worse without pressure or shear.

    the point of me posting is i dont know what really to do. i have an appointment to get pressure mapped in my chair (tho my cushion is a ride and it doesnt even come close to the wound) and hopefully get a perscription for a new bed. also ive been trying my best to stay off the wound and not create shear. i eat alot and the last time i was checked my albumin was in the mid 3's, they are hoping for 4. i take a fair amount of vitamin A, zinc, D3, C and l-arginine. i get plenty of fluinds and have very, very minimal spasms.

    HELP.....i dont want surgery but at this point im considering it. im really tired!!
    "Impossible is Nothing" - Adidas Slogan

  2. #2
    Hi,

    Is your sore the place where your osteomyelitis is?
    If you have osteomyelitis, are you on antibiotic therapy? Bone infections (osteomyelitis) do require antibiotic therapy.

    Regardless, you should not be sitting on a stage 4 sore and you should keep all pressure off or it will not heal well. The undermining could be due to your continued sitting and the osteo. A clinitron or dolphin bed could help but if you you are on another mattress, make sure you are turning and staying off the sore.

    You are doing the right things with your diet and intake and your albumin is acceptable.

  3. #3
    the osteo was originally diagnoised(sp) in the anterior illiaca crest and bone was removed. they then treated me imperically with 6 weeks of iv vanco and oral cipro, following it up with 4 weeks of another antibiotic that starte with a d and killed my stomach. when i was off them the necrotic tissue fell out and the bone was visible. they tested the bone of the sacrum and i had strep B. so now im about to finish a 6 week course of oral levaquin.

    as far as not sitting on it...the sore is on my sacrum and doesnt get sat on. my physiatrist is not worried about pressure in that spot while sitting(fyi...he is the lead VA physiatrist in washington, an associate proffessor at UW, and a main physiatrist at Harborview Medical Center in seattle). now my shoulders are a wreck from laying on them and my upper back is in severe 7ish pain from my spinal fusion.
    "Impossible is Nothing" - Adidas Slogan

  4. #4
    Senior Member lynnifer's Avatar
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    I would 'ask' for IV antibiotics again. 12 weeks worth to kill it ... are you seeing an infection specialist as well?
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  5. #5
    i see 3 infectious docs, 1 physiatrist, 1 physical therapist, 1 plastic surgeon, 2 wound specialist nurses, nurses come in and change the VAC 3 days a week and my PCP... im on antibiotics now which will have been almost 4 months this year and they said(the 3 id docs) the oral levaquin is the best for bone penetration with the strep B infectiion. problem is half my doctors are in my town the others 100 miles away.
    "Impossible is Nothing" - Adidas Slogan

  6. #6
    Senior Member lynnifer's Avatar
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    I think they're wrong but I leave that up to you and the smart people.

    IV Antibiotics are best for bones because they don't lose their strength while travelling through the gut, since they go right to the blood stream.

    Perhaps I'm wrong? It happens, lol!
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  7. #7
    all i kno is my veins have been tortured by iv antibiotics, not to mention im getting to the point of them not working. because of my level of activity i blow iv's out fast and picc lines have a cascading effect of: no working out, muscle atrophy, pain then finally depression.

    in all honesty im hoping a new bed that wont screw up my shoulders or place excessive pressure on my spine will be the solution.
    "Impossible is Nothing" - Adidas Slogan

  8. #8
    they said(the 3 id docs) the oral levaquin is the best for bone penetration with the strep B infectiion.
    all i kno is my veins have been tortured by iv antibiotics, not to mention im getting to the point of them not working.
    I've never heard of any bacteria that's sensitive to oral antibiotics but resistant to IV antibiotics.
    It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

    ~Julius Caesar


  9. #9
    i never once said it was resistant to iv antibiotics. all i was saying(without saying i suppose) is the second i get an iv its over. no more veins. the doctors cant explain why but it usually takes 2-3 iv nurse to be able to start one. and im the kind of guy that has garden hoses for veins.
    "Impossible is Nothing" - Adidas Slogan

  10. #10
    Ah, pronoun trouble. (Credit: Bugs Bunny)

    The sentence structure indicates that "them" (the things that are not working) refers to IV antibiotics, but you meant the actual IVs.

    Thanks for clarifying that.
    It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience.

    ~Julius Caesar


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