Results 1 to 10 of 10

Thread: Saccral Sore being stubborn

  1. #1
    Junior Member
    Join Date
    Jul 2012
    Location
    North Mississippi
    Posts
    13

    Cool Saccral Sore being stubborn

    I have a question for those here in the forum. I have a saccral sore. I developed it while in the hospital in 2008. It has see-saw'ed for this entire time but in the beginning was big enough to put a peach pit in. We now have it down to about 1cm, by 1cm, by 0.8cm deep. The WOC center that I go to currently, seems to have given up on it, cause she has thrown everything in the book at it and can get anything to stick, making it heal. It's high enough on my saccral area that I don't sit directly on it and my wheelchair has an opening in the back that prevents saccral pressure.

    I currently use Santyl because of all the things we have used on it, this has seemed to have the most effect on making it smaller. It seems that every time it gets to a certain point though, the WOC recommendation is to suppliment the medication with a packing (I am assuming to keep it from closing up on itself), but everytime we pack it, it "Runs" from the packing and gets larger.

    I am trying my best to not have to have a flap, because as most of you know, coverage under Medicare is sketchy at best and living in the middle of nowhere, my medical choices are Slim and None. The option would be to go somewhere else and then I would not have any familial support as my mom is the only one I have now. That and after the initial nearly 6 months in the hospital with SCI, I am reluctant to spend any more time in the hospital.

    Several MRI's over the years have shown no presence of latent bacterial or bone structure infection. The WOC even throws in some Doxycycline for good measure from time to time to make sure.

    We have used:

    Prixma
    Solosite
    Xenaderm
    Santyl
    Hydrocolloid
    Calcium Alginate
    Iodosorbe
    Regranex
    Silver Iodide
    Medi-Honey
    and many others

    Your help and experience would be greatly appreciated.
    Last edited by CubGuyMS; 08-03-2012 at 05:16 PM.

  2. #2
    I use medical honey on sores, including a couple small sacral ones recently. Main thing is to not pressure the sores at all, including shearing. My toilet seat was scraping my tailbone so I moved the cutout to the back and eventually the sores healed. I assume osteomyelitis has been ruled out.

  3. #3
    Senior Member lynnifer's Avatar
    Join Date
    Aug 2002
    Location
    Windsor ON Canada
    Posts
    19,320
    Electrical stimulation ... But that area is the #1 spot for wounds.

    A flap would strengthen the area ... Whereas to let it heal on its own would mean weak scar tissue there prone to breakdown.

    I spent 3 months in hospital at age 15 and missed a semester of school. The other patients in rehab were gracious enough to keep me company and offer support. Barely saw my parents or anyone during that entire time. Win/win as the others learned to take care of their skin!
    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

  4. #4
    Because you are packing it to tight ! or that is my thought.and no we don't pack small wounds necessarily we pack large wounds if they are draining. If that small and hewaling keep doing what you are doing and apply santyl and hydrocolloid on top, keep pressure off so why would you start packing if it healed that well?or if draining then pack a little bit. I doubt you need to pack it.
    Sanytl keeps it from having necrotic tissue and should granulate and heal. But if red and healing and no areas of yellow, white etc.. then may not need the santyl.
    Are you covering the entire area with santyl of a nickel thickeness and removing once a day or every other?
    Mini vac but if they are packing too tight with packing then they might pack too much foam!

    CWO

  5. #5
    Junior Member
    Join Date
    Jul 2012
    Location
    North Mississippi
    Posts
    13
    Quote Originally Posted by SCI-Nurse View Post
    Because you are packing it to tight ! or that is my thought.and no we don't pack small wounds necessarily we pack large wounds if they are draining. If that small and hewaling keep doing what you are doing and apply santyl and hydrocolloid on top, keep pressure off so why would you start packing if it healed that well?or if draining then pack a little bit. I doubt you need to pack it.
    Sanytl keeps it from having necrotic tissue and should granulate and heal. But if red and healing and no areas of yellow, white etc.. then may not need the santyl.
    Are you covering the entire area with santyl of a nickel thickeness and removing once a day or every other?
    Mini vac but if they are packing too tight with packing then they might pack too much foam!

    CWO
    @sci-nurse, Thank you for such a quick reply. I was thinking that the packing might be causing more pressure than needed on the sore thus making it "run" or widen away from the packing. The Santyl takes a long time to promote healing, but it seems to be doing the trick. Every time we go to the WOC she wants to know if its draining. We tell her no, and no maceration observed at any time and she looks at us like we are lying. When I first came home, my mom had to go and take two days of training at the Shepherd Center on how to care for wounds at home so she knows what to look for. Between that and wanting to cut it back and do an MRI every freaking time I go, I tend to wonder if it might be time to seek another WOC.

  6. #6
    Junior Member
    Join Date
    Jul 2012
    Location
    North Mississippi
    Posts
    13
    Quote Originally Posted by Craig80 View Post
    I use medical honey on sores, including a couple small sacral ones recently. Main thing is to not pressure the sores at all, including shearing. My toilet seat was scraping my tailbone so I moved the cutout to the back and eventually the sores healed. I assume osteomyelitis has been ruled out.
    Have used Medi-Honey before. It caused some excessive maceration in the surrounding tissue.

  7. #7
    Here is what I have at the top of my list of things to try if I get a stubborn wound. Procellera provides electrical stimulation and the antibacterial benefits of silver dressings. Compared to most high tech dressings, its price is reasonable. I have not tried them yet.

    http://www.imed.com/p/vomaris_procel...nt/222724.html
    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
    Junior Member
    Join Date
    Jul 2012
    Location
    North Mississippi
    Posts
    13
    Still have Silver Iodide dressings on the shelf that I no longer use. It grew larger under them too...Also have tried ReGranex with no success.

  9. #9
    You're going to think that I'm crazy, but you need to stop everything that you're doing right now, and go back to using a simple saline, wet to dry dressing. I've been dealing with these things for some 20 years now and when they get to the size where you are now, sometimes it's just best to get back to basics. It sounds as though you're in the early stages of SCI, yes? If that's the case the tissue in the musculature below that wound are most likely still firm and viable. Sooner or later, a flap surgery is in your future. Sometimes that is the only and best option. But for now take that tissue back to the basics. Keep the pressure off the wound, keep it clean and use wet to dry dressings. You may be surprised. Also, if you can, take collagen as a supplement. It hasn't really been proven to do anything but as far as I'm concerned, it WORKS!

  10. #10
    Wet to dry is not a good way to dress pressure ulcers. The goal should be to keep the wound moist all the time. We do use wet to MOIST, but you never want the gauze to dry out completely. If you do, when you remove it, you just rip out all the baby fibroblasts cells that are trying to cover the wound surface.

    How recently have you had a MRI? A wound that refuses to heal may be due to still having excessive pressure on the area, but also due to bone infection. What is your CRP blood level? How is your nutrition? What is your pre-albumin blood level?

    (KLD)

Similar Threads

  1. Am I just being stubborn?
    By JenJen in forum Care
    Replies: 19
    Last Post: 11-05-2007, 06:35 PM
  2. Yevgeny Kafelnikov: The 'stubborn Russian nut' who has given up tennis to play poker
    By Max in forum Recreation, Sports, Travel, & Hobbies
    Replies: 0
    Last Post: 11-15-2004, 03:53 PM
  3. Too stubborn for my own good?
    By TD in forum Caregiving
    Replies: 18
    Last Post: 09-26-2002, 12:24 AM
  4. Replies: 0
    Last Post: 05-29-2002, 05:21 PM

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •