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Thread: Lookin for help with a skin problem

  1. #1
    Member St Elmo's Avatar
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    Lookin for help with a skin problem

    I am starting this thread because I am looking for some “second” opinions on how I might heal this open area/wound more quickly. I could use some help understanding exactly what's going on here, or what's not going on, as the case may be. I'm pretty new to this forum but have been riding a chair for over 29 years (T4-5 complete)

    I basically never had any real skin issues until after 2 years ago when I had 2 months of thankfully, successful, daily radiation and weekly chemo treatments for squamous cell cancer that showed up attached to the lymph nodes in the left side of my neck. The short story is that I basically laid in bed with no teeth and didn’t eat for about II months. Going from a very fit (2 hours hard, on a handcycle every other day,)175 lbs. to a very bony 130lbs. 4 of those 11 months were spent dealing with very bad sores which I started on each hip mostly out of genuine ignorance added to gross/honest stupidity on my part, having never had skin worries before and certainly never having lost so much weight so quickly. A lot of things in life became new to me, hay, I’d never been there before.

    However my current situation is unrelated to those wounds as they are healed and looking fine and should have taught me not to ever let even a “little” skin thing not be immediately paid attention to, and taken seriously. That being said I was so gung ho about being back in training and trying to re-gain my health and some body mass that I just didn’t want to stop when the beaded edge of some depends type underwear that I was wearing for a few days rubbed a a little surface skin off right over the the lower boney spot (ischial?) on the right side of my butt. Didn’t have any padding there anymore. Anyway I saw it right away , and just wouldn’t lay off trainin and livin again and let it mature into a 1/4in in diameter stage 2+ that stayed the same look and size for months, so I kept at getting healthy again, figured I’d get it healed in Jan. and Feb. when it’s “winter” here in N. Florida and I wouldn’t mind staying in bed.

    However late last year it slowly started getting larger. I live by myself and am also a freelance illustrator and graphics designer and picked up a large job that took until about the 12th or so of Jan. to complete, and it took me a couple of more weeks to really talk myself into it and to re-do my apt. to live out of the bedroom again. During that time (8-10 weeks) it morphed into what can be seen starting the slide show I have posted on YouTube with the dates of the photos and the size of the open area in millimeters in each photo up top. I will keep this updated as I take new photos every few days. The link to this slideshow/movie is posted at the bottom here.

    I have been bandaging it with a piece of Alginate mat, covered with a section of Thin Duo-Derm, followed by a layer of gauze held on by cloth tape. I have supplied still shots of this process in the 1st of the attached JPGs I provided below. I have been rubbing in an aloe gel a coupla times before I re-bandage it. Also since the 7th of May I have been putting Derma’s Medi-Honey directly on it and, in the lower matt layer. It looked like we were doing well and it was healing, I thought, well enough, until in early April when it re-opened and then kinda stalled. During the time it re-opened I had to be up for full days, 3 days in a row, but that that had happened in March and it continued to heal fine then, so I wasn’t real worried because it was so close to being sealed, or so I thought. Overall the area and the skin around it look healthy to me and the surgeon I have been seeing about this since mid April. However I want to hear from somebody else. This is takin too damm long.

    Now, with all that being said, the last 4 days I have been using just a gauze patch, with nothing else and it looks smaller and good. I am including shots of the bandage and tape before I removed it, and then a shot of the inside after. These are in the 2nd attachment below. In the 3rd attachment below there are 2 more shots, trying, as best as I could, to get the edges of the open area.

    Again, I do live on my own and and have some assistance, but still must get up every day to feed myself and other basic stuff, usually for 2.5 to 3 hours total in 2 sessions, more every 3rd day for bowel movements, and if I can’t get somebody to go to the store for me. I am very well hydrated (lotsa water, NO soft drinks, those things’ll kill ya) and well fed, have no pressure redness at all and no hint of infection. As it is now, some of the area of whiter skin mostly on the right, more lower then upper, next to the opening is looking not really attached to the layer below it, and there is almost no drainage, as shown in the bandage photos below. Any suggestions on healing this thing quicker out there? Unfortunately I can spend only so much time off it, man hasta eat ya know. I have one crip buddy pushing the magnets idea on me, any feedback out there on that one? Talk to me people, I have a $i000.00 check from the Challenged Athlete’s Foundation labeled Handcycle Training sitting out there, that I’m just dying to spend on my PT/Trainer friend, 2 good cycles gathering dust, and a suntan that I aint getting. What say you?

    Here's the link to the slide show

    http://www.youtube.com/watch?v=GFMSX...ature=youtu.be
    Last edited by St Elmo; 05-29-2012 at 01:42 AM.

  2. #2

    Question Question about leeches and pressure sores

    This might seem like a dumb question BUT could leeches be used for the deeper type pressure sores? I know they use it in other type wounds.
    Helga

  3. #3
    Member St Elmo's Avatar
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    I don't thing that would apply here because we're not really dealing with dead skin or any kind of infection.

  4. #4
    Senior Member lynnifer's Avatar
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    Well crap. It's full thickness skin which is unfortunate .. but it does look clean and pink. Such a small area .. by now though, it's probably colonized ... are you sure it's not infected? Trust me I know that hindsight is 20/20 which you admit .. and I have been there too. Unfortunately the longer we are paralyzed, the more apt you are to develop a wound.

    Have you been seen by an infection specialist? Had an MRI to rule out a bone infection (though I doubt it by looking at it)? Should it ever start to deepen or 'tunnel' though - that would mean definite bone infection. Get a blood test for your iron levels ... that was a stumbling block to healing for me a few years ago. Paralytics seems to be prone to borderline anemia.

    Switched up your cushion or your mattress?

    I would not use just plain gauze on that .. and the tape looks to be irritating to the skin around. If you can get a barrier cream, that would help the area around (since it's dry and paralyzed so long you don't want to disturb it either).

    I'm partial to a dressing called Mepilex border ... it will keep the guck away from your wound (unlike the gauze) and act as a second skin. Do you clean the wound out with saline? Like, spray it right into the wound?

    Hopefully the nurse chimes in with some better advice ... I'm just an idiot who's had a lot of experience with wounds.

    Take a multivitamin!

    ETA: You're the black spot on the foot guy. Did it heal up?
    Last edited by lynnifer; 05-29-2012 at 01:35 AM.
    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
    Senior Member lynnifer's Avatar
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    I'd be interested in what a wound vac could do to that wound .. but it requires bed rest and weeks of commitment.
    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

  6. #6
    You need to make sure you don't have osteo underneath or somehting preventing it from healing but you need to stay off of it until healed.
    And dressing should be moist not dry. Pressure mapping done recently?
    High protein diet, vitamins?CWO

  7. #7
    In addition to the above suggestions, you might switch to a silver impregnated dressing such as Acticoat. The silver dressings help to reduce or eliminate any bacteria that may be interfering with healing.
    You will find a guide to preserving shoulder function @
    http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

    See my personal webpage @
    http://cccforum55.freehostia.com/

  8. #8
    Member St Elmo's Avatar
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    Mizz Lynnifer...I swear I’m not the black spot on the foot. I did post a reply, but it wasn’t my foot and haven’t checked that thread so I don’t know if it healed. I have a foam/gel pad on my bed with a thinner wavy foam pad underneath. It does have a kinda depressed area but when I’m setting up I try to vary my position frequently.
    On a daily basis I blend a large smoothie with 5-6 kinds of fruit, yogurt, a full multi vitamin and mineral with protein supplement, and an additional large scoop of whey protein thrown in. I am seeing the surgeon next week, always take my laptop with me to show him the progressive photos, and will show him this thread with everyone’s suggestions for us to discuss. He has mentioned about checking for infection even thought it is not visually evident, and I will be altering my treatment of this puppy. Thanks folks...keep it coming. remember......Accept, Adapt and Overcome

  9. #9
    for the first 3 days you have to wash it with hydrogen peroxide 3% and use silver dressing to clean up - this u have to make it 2 time per day...then u have to wash it with saline and use other dressing like tender wed 24 active ..wound healing base on wed therapy

  10. #10
    Member St Elmo's Avatar
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    Quote Originally Posted by SCI-Nurse View Post
    You need to make sure you don't have osteo underneath or somehting preventing it from healing but you need to stay off of it until healed.
    And dressing should be moist not dry. Pressure mapping done recently?
    High protein diet, vitamins?CWO
    Mizz SCI nurse...since I am seeing my Doc next Mon. about this, can you think of any specific things I should bring up, or questions I oughta pose? Again I do take my laptop so I can show him this thread with everyone’s suggestions and the photos of between when he sees it. Considering there’s no way I can stay off this totally, do you see anything wrong I’m doing with the bandaging and any ideas on where I should start looking to get the pressure mapping? Also...this is kinda theoretical, but why not? What do you think about what's more harmful...staying in the chair for a longer period concentrated on/in one day, or shorter periods spread over multiple days?
    Last edited by St Elmo; 05-30-2012 at 10:30 PM.

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