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Thread: Healing a Stage 1 Pressure Injury - Journal

  1. #1

    Healing a Stage 1 Pressure Injury - Journal

    I've been injured for 30 years. Up until last week, I have not had to deal with pressure sores. In the early years, I used a graduated temper foam cushion with an ischial cut out. Then, I used Jay cushions for a number of years until I grew weary of dealing with seams failing and that white, sticky gel mess. For about twelve plus years, I have been using Roho Quadtro cushions, replacing them about once every 3 years. Each cushion I have had has gotten a leak in it in the first 6 months. The leaks have been small enough to patch with Roho patch material and I have had few other problems.

    Before this incident, I had begun the process of getting a prescription for a new Roho cushion and submitting to my durable medical equipment supplier for processing. At this point, I am probably 3 or so weeks from getting a new cushion. This was a planned replacement, not a reaction to what has happened in the past 12 days.

    On March 7, NL and I were 2 hours into a 4 hour drive to attend a funeral. I began to get autonomic symptoms and we pulled into a rest stop to go through the check list of what might be the cause. When we checked my cushion, we discovered that I must have a leak in one of the quadrants of the cushion. Unfortunately, we didn't have a spare cushion with us, but we did have the Roho pump. We didn't have patch material with us. These leaks can be difficult to pinpoint without being able to submerge the cushion in a tub of water.

    At the rest stop, we pumped up the cushion and decided to return home rather than go on to the funeral. The cushion leaked, I experienced autonomia, we stopped and pumped up the cushion. We repeated this process all the way home, making numerous stops to pump up the cushion. Finally home, I got in bed and NL found a very bright red spot on my right ischium. The spot did not blanch and the skin was intact. We took a guess that this was a Stage 1 pressure sore.

    Both of us have read enough about pressure sores that we thought the best course of action to heal this sore was to keep all pressure off, laying on left side then right side with pillows propping my legs, back and shoulders to relieve all pressure on the right ischium. We turned every 3 hours.

    By morning the sore had taken on the deep purple color of a bruise. We worried that the sore might be a deep tissue injury, but knew we wouldn't know until the sore "developed more." We continued to keep all pressure off the area. We did not apply dressings or any preparations except for Cera Ve Moisturizing cream. The skin became thick, dry, and looked leathery like elephant skin. Fortunately, the sore did not develop into anything worse than a minor pressure wound, but it took 12 days from discovering the injury to being able to be up for limited periods of time yesterday and today. I'm using an older spare Roho cushion.

    NL took photos every day from the first day to provide us with a photo journal of the progression of a stage one pressure wound. We had no idea exactly what to expect. I talked to my physician on the phone and NL emailed him a couple of pictures. He concurred we were on the right track and the only thing to be done was to keep pressure off. I decided to post this story and some pictures to document the healing of this type of sore. The pictures posted represent the first day and roughly every other day after that. NL retouched photos or strategically draped my body to avoid showing body parts in these photos. I hope this photo journal will be helpful as a reference on Care Cure Community. I'll post 5 pictures on this post and follow with more pictures on subsequent posts.

    These first 5 pictures cover March 7 to March 14.

    All the best,
    Attached Images Attached Images     
    Last edited by gjnl; 03-19-2013 at 09:52 PM.

  2. #2
    The next 4 pictures are from March 16 to March 19.

    I think we really dodged a bullet here. I will gradually work up to my normal time in the chair. Whew!!! Glad this is behind me, so to speak!!!

    All the best,
    Attached Images Attached Images   

  3. #3
    Very useful information! I wish other people with pressure sores carefully described how they got them so we know what to watch out for. I have heard good things about roho but I think I have seen more than few stories here of leaking causing some terrible sores, you did dodge a bullet, probably due fortuitously if not ironically to the AD, and careful quick response.

    I need a new cushion myself I have been getting ischial redness after a few hours all the time unless I carefully weight shift every 15 minutes. No sores yet but i am in bed most of the time due to thus issue. It's just getting harder and harder for me to physically manage the weight shifts as my arm and shoulders just get too tired. Roho was suggested to me to consider. I am using stimulite now.

  4. #4
    Senior Member lynnifer's Avatar
    Join Date
    Aug 2002
    Windsor ON Canada
    Unfortunately a lot of people live on their own or must work for their only income so taking this amount of time off or preventing it from being worse without someone to help them isn't an option.

    There are a lot of factors involved in wounds.

    Glad you dodged a pain in the butt though!
    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 wtf's Avatar
    Join Date
    Jan 2004
    silver state
    Yes you did dogde that one from getting worse. Thanks for documenting, pictures tell a thousand words. Your skin looks healthy overall, I'm glad the sore didn't open up. Like Lynifer said your fortunate you could stay of it which is what one needs to heal a sore.
    A dolla makes me holla, honey boo boo! - borrowed from Honey boo boo child

  6. #6
    Good to hear things are looking better.

  7. #7
    you were extremely proactive in preventing a serious wound. glad all is better.

  8. #8
    Senior Member
    Join Date
    Jan 2004
    Whately, MA United States
    Blog Entries
    GJ, glad that you had the resources to treat this sore correctly. Wish I had done the same 8.5 years ago. It would have saved me 5 months in the hospital. I was fortunate to have the VA to bail me out, but most folks are not.
    Don - Grad Student Emeritus
    T3 ASIA A 26 years post injury

  9. #9
    This is really helpful. Thank you for sharing. So glad that things are improving so quickly.

  10. #10
    Progress report.

    I am back up in the chair for a few hours every day and using an older Roho, and it is giving good support. I am awaiting the Roho Custom Select cushion that I had on order before this sore developed.

    Tom Borcherding, president of Roho posted a message to me on another thread, and I have contacted him through the email he provided. He is trying to get the shipment of my new cushion expedited and he is sending a call tag for the cushion that I am replacing so that Roho can do some testing.

    NL submerged the cushion in a bath tub full of water and has identified the area that was leaking. There is a least one pin hole leak, and possibly two. It will be interesting to hear back from Roho about the failure cause.

    All the best,
    Last edited by gjnl; 03-21-2013 at 03:26 PM.

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