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Thread: How long for a SPC to heal?

  1. #1
    Senior Member ~Lin's Avatar
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    How long for a SPC to heal?

    How long does it usually take for a suprapubic catheter site to heal around the catheter? I have slower than normal healing as a result of my genetic connective tissue disorder, but I'm wondering if I should be a bit concerned. I had it done Sept 5th so 2 weeks ago. It was looking really good, and this past Tuesday I started to use a valve during the day. On Thursday I noticed it was looking a bit worse instead of better, and seemed more damp than usual when I changed the dressing and hooked up the night bag. I smelled the dressing and it smelled a little like urine, so I think I leaked out the site some. I really want to use the valve during the day, I waited a few days over a week before the first time I used it because of my slower healing but I guess I'm not healed enough still. I wore the valve only for a few hours yesterday when I went out for an appointment, and kept the bag on all day today.

    It used to look "dry", but now it looks like what lines the inside of the tunnel is wet and maybe sloughing? I wasn't taping the catheter to myself at all because I needed to let the skin heal, (adhesive allergies) just taped the catheter to the dressing and with the dressing around it in such a way to keep the catheter going straight up and not pulling in any direction. Then my underwear would hold it in place. Yesterday I went ahead and taped the catheter and the top of the dressing to my skin a bit to better stabilize it, and went without underwear last night and today with loose cotton PJ pants. I thought as much airflow as possible might be best. Here are some photos of it changing the dressing about an hour ago, the red is scar tissue I haven't noticed any infection signs. I cropped them rather tight due to the sensitive nature of that area, and one is a bit blurry (shaky hands).

    http://i38.photobucket.com/albums/e1...psa411d5a6.jpg
    http://i38.photobucket.com/albums/e1...ps40108b7e.jpg

    I also figured out a way to connect the night bag to the valve. I started thinking it would be easier if I could do so. I had already tested out attaching the end of some extension tubing to the valve for use in public restrooms. So I went ahead and tested attaching it all the way down the end of the valve so it wouldn't leak or slip, and then attaching it to the night bag and it worked. So when I hooked up my night bag yesterday I cleaned the end of the valve out with alcohol, cleaned the short piece of extension tubing, and the night bag attachment. I'm hoping in addition to just being easier, that this may be less infection risk that completely disconnecting and changing out items. Here is a picture:

    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  2. #2
    Senior Member Donno's Avatar
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    Doesn't look too bad, other than the whitish spot. I put in a foley overnight every night (no SP), and I spray all of the connections with HydroCleanse, including a couple of spritzes to the tip of my penis and the first 3 or 4 cm of the foley You may be able to get 4 16 oz bottles free:


    Oculus Innovative Sciences is making limited quantities of free samples of HydroCleanse available to members of our Care Cure Community. These free samples will come in 16-ounce plastic spray bottles. Beginning Monday, September 8, you can make arrangements to receive your sample by calling 1-800-759-9305 in the United States and 678-213-0657 outside of the United States. The call center will be open from 8:30 AM to 5:00 PM Eastern Daylight Time (EDT).
    Don - Grad Student Emeritus
    T3 ASIA A 25 years post injury

  3. #3
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    To further elaborate on Donno's comment. HydroCleanse is a wound care product akin to Microcyn (and the former Vetericyn/Vetericyn VF before they were relabeled Veteryn Plus and Vetericyn VF Plus

    http://sci.rutgers.edu/forum/showthr...cyn+wound+care

    http://sci.rutgers.edu/forum/showthr...cyn+wound+care

    All the best,
    GJ

  4. #4
    Senior Member ~Lin's Avatar
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    Thanks guys, I actually got some samples and they just arrived a few days ago, I was actually thinking about posting a "vetericyn/hydrocleanse for dummies" thread asking about how to use it as a bladder instillation to prevent UTI, how regularly (though I know that varies a lot, for me prior to now I haven't had a lot of UTIs and I just want to try to keep it that way). I've read various threads on it, and pieced through parts of the huge thread... But its so huge! lol. So I thought beyond my interest it might be nice to have some sort of "dummies" condensed version or FAQ on its own. Does anything like that already exist?

    The "whitish spot" is what used to be dry and kind of lining the site on the inside. Its really more beige or maybe slightly yellow in person. But after the other day where the dressing was more wet than usual and the whole site looked more wet, its looked more like snot. Its not anything that wipes off or out, I took a pair of forceps and pinched it and pulled ever so lightly to see if it was anything loose. The part that actually worries me is the left side not filling in, it pretty much looks the same as the day of the surgery as far as thats concerned. You can see the suture looking down into it. The edges have been building up as scar tissue, I have a tendency for hypertrophic scarring, but it hasn't really filled "in" at all and I wondered if it should have started by now. But then I had ingrown toenail surgery (both sides of both big toes, more removed on the midline side) this past spring though and its really not fully filled in yet, just looks weird close up and slowly improves.

    At what point does it generally stop oozing? I can't remember from my research but I do know I read that usually by a certain time people don't need to apply a dressing any longer. I don't see my urologist until the first catheter change in another 2 weeks, and with it kind of going backwards in the healing process I wondered if I needed to get someone to look at it sooner. My delayed healing and skin issues were my only real hesitation before the surgery, since its so easy to reverse. But I never managed to find someone with my genetic disorder who had one longterm, only someone who had one put in temporarily and she doesn't have the same specific type of the disorder so not the same skin issues as me anyway.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  5. #5
    It generally takes 2-4 weeks to heal, so you are in the ballpark. It does not look bad except for that one spot. I would call the surgeon and let him know of your concern. Given the uniqueness of your disease process, hey may want to take a look at it.

    You can try using the hydro cleanse on it. Just let your surgeon know you are doing it.

    let us know if we can be of further help.
    ckf

  6. #6
    Senior Member ~Lin's Avatar
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    By the one spot do you mean the left side where its not filling in? If you mean what was earlier referred to as the "white spot" like I said thats what the entire lining looks like, its just without moving the tube around it shows the most on the left since the open area hasn't filled in. My surgeon had referred to the healing process as like an earing/piercing, so I guess I'll refer to it as a fistula for now. The white looking stuff (which is actually more beige or light yellow in person) lines the entire fistula. It was even more beige looking before the site started looking so wet, it sort of looked like a dryish film lining the entire area I guess. Then when things got "wet" it sort of swelled up a little to the current appearance where it looks like snot, and I tested out if it was something that could wipe off or pull out, but its still lining the entire fistula and firmly attached. There was no pain by slightly pinching it with the forceps and pulling lightly.

    Going without underwear and keeping the bag attached hasn't dried it out again to the former appearance yet. I'm back to wearing underwear though, don't feel comfortable with out it and the bottom of the gauze dressing would move around since its not secured. I'll continue with using the bag as much as possible and only using the valve alone when I have to, and when I'm using the valve I'll check the dressing regularly to make sure its not getting too damp/too much discharge and see if it smells like urine when I change it to test for leakage. I really prefer using the valve, it made an immediate difference in the spasms I was experiencing nonstop, where even with the bag at night they didn't get as bad. But with the bag for a couple days straight they're just about as bad as they were before starting to use the valve so I hope it heals enough soon! I'll at least call my urologist to comment about that since he said I could start using the valve after a week, I waited longer than a week yet its still not fully ready I guess.

    So with the HydroCleanse do you guys mean at the site? I'll start doing that and see if it helps. With the daily dressing change and cleaning I've been using a combination of just soap and water in the shower, baby wipes/bzk wipes, and iodine swabs plus baby wipes/bzk wipes. I have a bunch of these iodine swabs from the catheter kits while I was in the hospital for cellulitis, I didn't like using them so I used my own bzk wipes before cathing and didn't want them to be wasted so I started tossing the packages into my backpack. After the surgery I thought they might be useful for cleaning the site, so I'll swab it all around the tube, press down to release the iodine, and then clean the iodine off with a wipe before applying the clean dressing.

    When should the drainage/discharge stop?

    Due to the amount of scar tissue thats already built up without it having filled in at all yet around the tube I'm already thinking I may need steroid shots in it once its fully healed, scar tissue has a tendency to be painful for me as well as the hypertrophic build up so I'll probably discuss it with my dermatologist once its fully healed. Unfortunately I'm also resistant to the steroid shots or something, because in the past its generally taken a round of 3, then built back up, and another round of 3. I wouldn't care if it wasn't for the somewhat sensitive nature of the area and the fact its not a regular surgical site that will completely close but is going to always have the tube there, so I don't want it to be extra sensitive and painful.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  7. #7
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    Quote Originally Posted by ~Lin View Post
    By the one spot do you mean the left side where its not filling in? If you mean what was earlier referred to as the "white spot" like I said thats what the entire lining looks like, its just without moving the tube around it shows the most on the left since the open area hasn't filled in. My surgeon had referred to the healing process as like an earing/piercing, so I guess I'll refer to it as a fistula for now. The white looking stuff (which is actually more beige or light yellow in person) lines the entire fistula. It was even more beige looking before the site started looking so wet, it sort of looked like a dryish film lining the entire area I guess. Then when things got "wet" it sort of swelled up a little to the current appearance where it looks like snot, and I tested out if it was something that could wipe off or pull out, but its still lining the entire fistula and firmly attached. There was no pain by slightly pinching it with the forceps and pulling lightly.

    Going without underwear and keeping the bag attached hasn't dried it out again to the former appearance yet. I'm back to wearing underwear though, don't feel comfortable with out it and the bottom of the gauze dressing would move around since its not secured. I'll continue with using the bag as much as possible and only using the valve alone when I have to, and when I'm using the valve I'll check the dressing regularly to make sure its not getting too damp/too much discharge and see if it smells like urine when I change it to test for leakage. I really prefer using the valve, it made an immediate difference in the spasms I was experiencing nonstop, where even with the bag at night they didn't get as bad. But with the bag for a couple days straight they're just about as bad as they were before starting to use the valve so I hope it heals enough soon! I'll at least call my urologist to comment about that since he said I could start using the valve after a week, I waited longer than a week yet its still not fully ready I guess.

    So with the HydroCleanse do you guys mean at the site? I'll start doing that and see if it helps. With the daily dressing change and cleaning I've been using a combination of just soap and water in the shower, baby wipes/bzk wipes, and iodine swabs plus baby wipes/bzk wipes. I have a bunch of these iodine swabs from the catheter kits while I was in the hospital for cellulitis, I didn't like using them so I used my own bzk wipes before cathing and didn't want them to be wasted so I started tossing the packages into my backpack. After the surgery I thought they might be useful for cleaning the site, so I'll swab it all around the tube, press down to release the iodine, and then clean the iodine off with a wipe before applying the clean dressing.

    When should the drainage/discharge stop?

    Due to the amount of scar tissue thats already built up without it having filled in at all yet around the tube I'm already thinking I may need steroid shots in it once its fully healed, scar tissue has a tendency to be painful for me as well as the hypertrophic build up so I'll probably discuss it with my dermatologist once its fully healed. Unfortunately I'm also resistant to the steroid shots or something, because in the past its generally taken a round of 3, then built back up, and another round of 3. I wouldn't care if it wasn't for the somewhat sensitive nature of the area and the fact its not a regular surgical site that will completely close but is going to always have the tube there, so I don't want it to be extra sensitive and painful.
    Lin, for what this suggestion is worth, if I were you, I would stop using all of the different products (baby wipes, BZK wipes, iodine--I suppose you mean betadine or povodine, even soap and water) you are using on your new suprapubic site and just use HydroCleanse which is an over the counter formulation of Microcyn for wound care. With all the products and chemicals you are using on this healing suprapubic site, you may be doing more harm than good.

    All the best,
    GJ

  8. #8
    Senior Member Donno's Avatar
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    Quote Originally Posted by gjnl View Post
    Lin, for what this suggestion is worth, if I were you, I would stop using all of the different products (baby wipes, BZK wipes, iodine--I suppose you mean betadine or povodine, even soap and water) you are using on your new suprapubic site and just use HydroCleanse which is an over the counter formulation of Microcyn for wound care. With all the products and chemicals you are using on this healing suprapubic site, you may be doing more harm than good.

    All the best,
    GJ
    Lin, X2 for what he said!
    Don - Grad Student Emeritus
    T3 ASIA A 25 years post injury

  9. #9
    Senior Member ~Lin's Avatar
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    I have to disagree there, I'm using what was instructed by my Dr and cleaning it every day as instructed by my Dr. I don't feel it's negatively affecting me in any way, as things were looking quite good until the usage of the valve and leakage at the site set me back. It's finally "dried" up back to how it looked before, so if I should avoid using too many things it would make more sense to not add in hydrocleanse, especially since it would be being wiped off immediately anyway since the site needs to stay dry.
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

  10. #10
    Senior Member Donno's Avatar
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    The best reason to use only HydreCleanse is that it does the job of the betadine and BZK (kills bugs) - AND - it actively aids in healing. Your doc does not recommend HydroCleanse because it is not currently a well known product. Years ago, many hospitals used electrolyzed water for disenfectant and wound healing. the device used to make electrolyzed water runs about $20K and the shelf life is very short. Oculus has figured out a method of keeping it active for over a year.
    Don - Grad Student Emeritus
    T3 ASIA A 25 years post injury

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