I have a stage 4 pressure sore on my left ischial. It opened in September 2011. I did not know it was there, nothing visual, just sweating on the left side of my head that went away when I changed positions. I was treated with a wound vac until mid December, but the wound would not heal. I had surgery on Dec 15th to debreed the wound and check the bone for osteomyelits. The bone biopsy came back negative, but the MRI showed osteomyelits present. The wound was opened to about the size of a plum and I was hooked back up to the wound vac. I took Zyvox for 24 days, two times a day but my platelet and white blood cell count when down very low and my liver enzymes rose. I was changed to IV Vancomycin on January 20th and have that administered twice a day. The wound began healing and is now the size of a small oval grape. The tunnel that was present was originally about 7 cm and is now down to 1 cm.
Everything else has filled in nicely.
My plastic surgeon is from Loyola University Medical Center and is the lead plastic surgeon for the VA hospital associated with it. He is very familiar with pressure sores. His opinion is that I should have flap surgery. I am very healthy right now and the sore is at a stage that he feels that it would be a small flap surgery and a quick recovery. The wound is healing so fast at this point that I am wondering if I should just let it heal on it’s own, using the wound vac, or if I should have the surgery. My wound nurse wanted me to have the flap surgery months ago, but I just wasn’t healthy enough at the time. I have been laying in bed for five months and I want the best long term solution. Am I better off having the surgery or letting it heal as I have been.