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  1. #1

    Flap Questions

    Hi everyone,

    I have a stage IV ulcer that began last June because my damn insurance company provided me with a "standard" mattress instead of a "low air loss mattress while transitioning from a 19 consecutive months in a nursing home to an apartment. My insurance company provided me with a "standard" mattress instead of a low air loss mattress because according to Medicare guidelines, they won't provide anyone with a low air loss mattress until you have a stage TWO wound. They didn't provide me with the correct mattress until I called them letting them know I was in the hospital with it progressing to a infected stage IV. They didn't hesitate and delivered my low air loss mattress that afternoon. Long story short, shortly after I returned home from the hospital and into my apartment, I had to go on IV antibiotics along with a wound vac. I could only carry on a couple of weeks maintaining the IV antibiotics along with the wound vac.
    ten with my caregiver helping me out. I was forced to surrender my apartment of only two months and was forced to move back into a nursing home apartment and transfer back into nursing home after only two months in m own apartment .

    I am finally having a consultation for a flap on March 5 and the wound used to be 15cm x 16cm and a depth of 5cm. It is currently 3cm x 3cm with a depth of 2 cm and it also has undermining. In addition, it has a little bit of slough but not a lot. It has no escar present. Overall, it is beefy red. Under these circumstances, do you think it is healthy enough to move forward with a flap based on individuals who have had flaps in the past?

    Thank you,

    Michael

  2. #2
    Hi Michael,
    Sorry to hear that you are going through this. I had the flap last January 2011. Have you been tested for osteo? You won't be able to have the flap if osteo is present. Is the surgeon you are meeting with an experienced flap surgeon? I talked with a few surgeons. Some very inexperienced and some with so so success. I finally found the one with high success rate who had performed hundreds of them. Mine has held up well for over a year now. Following all the post op rules to a T and then some will play a key role in making it successful too. I'm sure SCI-Nurse will be commenting soon to give you some advice on this situation. Good luck to you.
    DFW TEXAS- T-10 since March 20th, 1994

  3. #3

    Smile The Flap

    Hello, I went threw the same situation as you did with my ins company and the mattress. I also had a bedsore that went to the bone and got infected. I went threw the wound vac thing too, The flap surgery was done and afterwards i was put on an air/sand matteress for 44days until it healed completely. Two doctors told me it was completely healed so I informed the nursing home that I was going home to live my life. The director of nurses tried to force me to stay in the nursing home for another year, but I wasnt having that, I told him that I was a grown woman, I could think for myself and I'll do what I want and if he had a problem with it, then get over it !
    Right after that I texted all my family and let them know the situation, man they showed up like a pack of wolves ! He got told off and we left....
    Good luck on your situation, I hope you come threw this alright.
    Last edited by cheryls wheels; 02-29-2012 at 02:02 PM. Reason: mispelled words

  4. #4
    Even more important than the appearance of your wound would be the following:

    Have you had tests to rule out any osteomyelitis? If you had this, and it was treated, have you had tests to determine that the treatment was successful?

    What is your CRP blood level? Your albumin level? Your pre-albumin level? If this are not right, a flap has a high chance of failure.

    What are your current hemoglobin and hematocrit levels?

    Are you prepared for the extensive bedrest and activity restrictions following flap surgery? Where will your recover? Your care and compliance with these restrictions will be critical to your success.

    How experienced is your physician and the nursing staff where you will be recovering in caring for persons with SCI having flap surgery?

    What kind of bed will you be on immediately after surgery?

    (KLD)

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