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Thread: Sore tunneling

  1. #1
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    Sore tunneling

    I have a sore that we have been working on for a couple months. It started off as a byte or something like that. It had a little puss area to start off. We popped it and it looked okay. A few days later it had a red spot in the middle of the area. Next thing we know there is a hole. We contacted a wound care doctor he said it was tunneling and started to pack it. After a week or so he started having us flush it with saline. That seemed to work pretty good. The tunnel went from 7cm to 4cm in a couple weeks. Then it stopped getting smaller so he had us use medihoney for a couple weeks and the tunnel stayed about the same. He now has us doing nothing just leaving it dry. There is hardly any drainage at all. My question is. Shouldn't we be using something to debride it so new tissue can form? It is only .8cm deep and the tunnel is around 4cm. Any information is appreciated.
    Last edited by HACKNSACK44; 05-13-2012 at 08:45 PM. Reason: na

  2. #2

    sore

    Dear HACKNSACK44
    The sore sounded like it started out as an infected hair follicle (folliculitis) and turned into an abscess. I'm surprised that you don't have anything covering the wound. If in doubt go back to the doctor, especially if it is not improving.

    pbr

  3. #3
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    Quote Originally Posted by SCI-Nurse View Post
    Dear HACKNSACK44
    The sore sounded like it started out as an infected hair follicle (folliculitis) and turned into an abscess. I'm surprised that you don't have anything covering the wound. If in doubt go back to the doctor, especially if it is not improving.

    pbr
    Thanks for the reply. What you are describing sounds right. I just saw the doctor Friday and that's when he said to leave it alone. Don't put anything inside. We are to keep the .8cm hole open so the tunnel will heal up first. I keep a bandage over it so nothing gets into it.

  4. #4
    Quote Originally Posted by SCI-Nurse View Post
    Dear HACKNSACK44
    The sore sounded like it started out as an infected hair follicle (folliculitis) and turned into an abscess. I'm surprised that you don't have anything covering the wound. If in doubt go back to the doctor, especially if it is not improving.

    pbr
    yes,‘Tunneling’ refers to a wound progressing deeper into the body as opposed to growing in surface area. Tunneling bed sores (or decubitus ulcers, pressure ulcers or pressure sores) can be difficult to treat because their outward appearance may be misleading. Tunneling wounds often involve areas larger than those that appear to be involved.

  5. #5
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    Quote Originally Posted by HACKNSACK44 View Post
    I just saw the doctor Friday and that's when he said to leave it alone. Don't put anything inside. We are to keep the .8cm hole open so the tunnel will heal up first. I keep a bandage over it so nothing gets into it.
    If he doesn't want you to pack it, how does he expect you to keep it from healing across the top first?
    T7-8 since Feb 2005

  6. #6
    I agree. You do not want it closing over the top.

    Is there slough or eschar visablee? How do you know it needs to be debrided?

    What are you putting on the wound? How are you cleaning it? I assume you are staying off it entirely during this time?

    (KLD)

  7. #7
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    Thanks for the replies. We are using the end of a sterile syringe twice a day to keep the top from closing. We insert the syringe and move it around to keep the hole open. Then we use a sterile Q-tip with saline to go inside the hole and that's all we are doing with it. That's why I'm asking. I'm definitely not a doctor but I would think packing it with something and removing it would allow for new tissue to grow. Yes I am staying off of it.

  8. #8
    Quote Originally Posted by HACKNSACK44 View Post
    That's why I'm asking. I'm definitely not a doctor but I would think packing it with something and removing it would allow for new tissue to grow. Yes I am staying off of it.
    I had the same thing 6 years ago. I referred to it as a worm hole.
    You are correct in saying " I would think packing it with something and removing it would allow for new tissue to grow."
    My wife did mine I believe twice a day with a treated material that seemed like a cotton shoe lace. It healed fast.

    Good Luck
    Wish I didn't know now what I didn't know then.
    Bob Seger

  9. #9
    Quote Originally Posted by tvot View Post
    I had the same thing 6 years ago. I referred to it as a worm hole.
    You are correct in saying " I would think packing it with something and removing it would allow for new tissue to grow."
    My wife did mine I believe twice a day with a treated material that seemed like a cotton shoe lace. It healed fast.

    Good Luck
    Probably NuGauze. It comes in 1/4", 1/2", 1" and 2" widths. You cut off the amount of the long strip you need, and moisten it with normal saline or Dakins before lightly packing into the wound. It comes in a jar.

    (KLD)

  10. #10
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    Pic..
    Last edited by SCI-Nurse; 05-14-2012 at 09:54 PM.

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