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Thread: Recovery after girdlestone surgery?

  1. #1

    Recovery after girdlestone surgery?

    I need help or insight on recovery time from girdlestone surgery.


    A little background, this past year I developed an infection on my right hip. My orthopedic surgeon preformed four surgery's to clear the infection, the last one in August resulting in removing the head of the femur and instead of sewing me up like before I was put on a wound vac. The first couple months the wound healing was going well but the last four to six weeks healing has came to a near standstill. The wound nurse has taken me off the wound vac a couple time where me-salt dressings were changed twice a day hoping to kick start the healing.
    Two weeks ago the wound nurse suggested me seeing a plastic surgeon to finish up on the healing progress. My doctor has referred me to Harborview Medical center in Seattle.


    I’m wondering if others that have had a girdlestone procedure done what type of recovery time they had and did they have to finish the healing with a flap and skin graft surgery? What kind of recovery time will I be looking at for yet another surgery to finish the healing of the wound? This wound is not on my butt but on my right side so pressure from sitting will not be an issue but my hip is constantly moving from twitching, spasticity, weight shift and just normal daily living.


    Any advise, ideas, or thought would be appreciated.
    Randy

  2. #2
    I am surprised at your report. I had the same procedure done to my left hip because of infection in 2006. I had a drain for about 10 days post surgery. I was on a heavy course of IV antibiotics for a week. Additionally, my hip socket was filled with a plastic type material impregnated with gentamicin. There was little drainage at the 10 day mark and the drain was removed. It was healed over in about another week. The staples were removed and I was completely healed in about a month.

    A word of warning: When you begin sitting again get a seating evaluation. You will be tilted to that side and likely develop a severe curvature in your spine if uncorrected. This was overlooked and I am now dealing with the consequences.

    I started sitting about a week post surgery to minimize deconditioning.
    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/

  3. #3
    In my experience, if you require a flap to close a girdlestone wound that did not heal, it is pretty much the same as a flap for a pressure ulcer...6 weeks of total bedrest after the surgery (if all goes well), then a progressive sittiing program that takes about 3 weeks to go from 30 minutes a day to 4 hours twice daily sitting. Although the trochanter area is not the same as an ischium, you still get pressure there, and more importantly, stretch, when sitting, so sitting too soon can cause the flap to break down.

    Is the wound still open all the way to the bone or joint?? Have they considered use of a matrix dressing (Oasis or Matristem for example) to try to "kick start" the healing?? How are you eating? What is your current CRP and pre-albumin levels?

    I would have a serious discussion about this with the plastic surgeon regarding time-lines in his/her experience with this type of wound healing. I assume that the osteomyelitis has been successfully treated and that your CRP, sed rate, and white count, and wound MRI all all indicating that the osteomyelitis is cured. If not, then you may need further antibiotic treatment and possibly more debridement first.

    (KLD)

  4. #4
    "In my experience, if you require a flap to close a girdlestone wound that did not heal, it is pretty much the same as a flap for a pressure ulcer...6 weeks of total bedrest after the surgery (if all goes well), then a progressive sittiing program that takes about 3 weeks to go from 30 minutes a day to 4 hours twice daily sitting. Although the trochanter area is not the same as an ischium, you still get pressure there, and more importantly, stretch, when sitting, so sitting too soon can cause the flap to break down.

    Is the wound still open all the way to the bone or joint?? Have they considered use of a matrix dressing (Oasis or Matristem for example) to try to "kick start" the healing?? How are you eating? What is your current CRP and pre-albumin levels?

    I would have a serious discussion about this with the plastic surgeon regarding time-lines in his/her experience with this type of wound healing. I assume that the osteomyelitis has been successfully treated and that your CRP, sed rate, and white count, and wound MRI all all indicating that the osteomyelitis is cured. If not, then you may need further antibiotic treatment and possibly more debridement first."

    (KLD)



    KLD,
    I'll see if I can answer some of your questions:
    I had blood drawn today and have a Dr. appointment Monday afternoon and will have the most current labs results after that. I do know my lab indicators are constantly improving. The only one I remember was sed-rate. During the time in the hospital in April and May my sed-rate was in the high 90's, its slowly been coming down and the last one three weeks ago was 44. I’m really trying to get 100 g of protein in my diet, thru food, high protein drinks and mixing whey protein shakes. I also try and keep Juven in my daily diet but I have to order it and about half the time I forget before running out.


    I haven’t heard of Oasis or Matristem dressings, but will ask my wound nurse about them. The wound is approximately 50/60% healed at this time but the wound nurse when she measured today said there is a small tunnel, about big enough to put finger about 2 ½” so nearly to the bone. The top of the wound is trying to close but they want this tunnel healed first. The wound nurse is thinking the wound vac may heal it eventually as there is slight progress but just very slow. A recent MRI 2 weeks ago the Dr. thinks there is some Osteomyelitis going on. I was on I.V. Nafcillin for 8 weeks post surgery and from then on Levaquin which I’m currently still taking.


    I was back in Denver for a re-val at Craig in November, they didn’t seem to concerned with my wound or wound vac. Your suggestion of time line and experience of plastic surgeon makes me think maybe I should consider Swedish and Craig hospital. My Dr. first talked about instate in Anchorage, but I suggested somewhere warmer. Dr. graduated from UW medical school so he is familiar with this hospital and there services and its the closest to Alaska so that’s why were talking Harborview in Seattle.


    In hindsight I’m thinking sitting up right away, going right back to work may not have been the most prudent thing to do. I question how I can lay in bed for bed rest for six weeks without moving my hip. I've had phenomena right after injury and I’m scared to death to lay flat for that long. I did get a phenomena shot leaving the hospital in May but I feel I need to sit up to breath. I cannot sleep on my back so I sleep alternating from side to side with knees tucked to help with spasticity.


    Thank you for your information,
    Randy

  5. #5
    A word of warning: When you begin sitting again get a seating evaluation. You will be tilted to that side and likely develop a severe curvature in your spine if uncorrected. This was overlooked and I am now dealing with the consequences”


    SCI for 55,
    At my re-val at Craig in November the Pt. noticed I’m already sitting left hip low, tilted and my spine is curving. She ordered me a new Jay cushion I can shave to straighten out the hips hip and a new Jay back to keep me centered. It hasn’t arrived yet but thinking with Christmas probably shipping has slowed down.
    Thank you,
    Randy
    Last edited by Bluff; 12-29-2012 at 01:54 AM. Reason: double wording

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