Page 1 of 2 12 LastLast
Results 1 to 10 of 11

Thread: Pressure ulcer created while in Clinitron bed!

  1. #1

    Pressure ulcer created while in Clinitron bed!

    I had flap surgery at the Dallas VAMC on January 11. After surgery I was placed into a Clinitron-type bed (essentially a black-ringed oval tub with a white porous sheet over air-liquidized silica). I am 6'7" tall and have contractures in my legs. As a result the bed is somewhat of a tight fit and my exterior ankle bones are in constant contact with the bed's surface since my legs are splayed out rather than straight and flat. I have to take care not to allow my knees to rest or press against the black rubberized rail.

    I have never had pressure ulcers; my surgery was for a bursa which resulted in an incision and drain. The wound bed never healed and after attempting a wound vac and various dressings, I returned to the VA for flap surgery. The surgery went very well, the wound is healing "perfectly" (according the surgeon he "couldn't be happier") and all seemed well.

    I have taken very good care of my skin the last 36 years and have never had issues with ulcers. However my wife examined my feet today and discovered something that was horrifying to me: a pressure ulcer on my right ankle.

    Two days ago there were six power outages, starting at around 11pm and occurring throughout the night, with the last occurring at 6:50am. Although the bed was connected to emergency power, it also failed. The bed turned into a hard, yet conforming surface. Each period lasted from five to ten minutes. The nursing staff had no explanation for the power outages since the weather was perfect.

    When doing bowel care I am rolled to my left side and the power to the bed is cut. I then lay on the silica bed anywhere from one to two hours before the bed is again energized and I begin to "float."

    What can I do to prevent further pressure ulcers? I am very concerned at this point.
    Attached Images Attached Images  

  2. #2
    Sorry this happened to you.
    The area of pressure looks more than two days old though.
    Did the Dallas VA lose power during the Packers-Cowboys game earlier this month? That storm hit us hard with loss of power the next day.
    Your ankle must have had contact with a hard surface. Maybe in the OR, maybe in the bed.
    Proper positioning in a functional Clinitron bed should not have done this .
    Hopefully this will heal quickly with Mepilex dressing and proper positioning.
    As your SCI doctor if a Prevalon boot can be applied when you're turned and the bed is off.

  3. #3
    The power was lost on January 27, so it wasn't during the storms. As I said "the weather was perfect."

    My right foot was never on any surface than the Clinitron; I checked continuously since I was cautious about contacting the aforementioned rubberized rail.

    Thanks for the suggestion for the Prevalon boot. I'll bring it up with my doctor.

  4. #4
    It does not look like it just happened, but I am not sure it happened in the OR. At this point, It doesn't really matter how it happened so much as how to heal it and prevent further ulcers from forming. The prevalon boot is a great idea. Also, make sure you get seen by the wound care nurse. It is difficult to say what type of dressing from a picture but they are a great resource. I would also encourage you to increase your protein and calorie intake. Fluids as well. The clinitron bed can really dry you out!
    ckf

  5. #5
    The nursing staff is conflicted over the use of boots in a Clinitron, so I am not sure that is an avenue of inquiry I can continue to pursue as an "uninformed" patient. However, I will ask again.

    My prealbumin is at 23 and I am consuming at a minimum 60 extra grams of protein each day (Gelatein) as well as six hard boiled eggs. I am a vegetarian so my protein intake is via diary and eggs; I am also on a low oxylate diet, so my consumption of legumes is greatly restricted.

    I am drinking three liters of water every 24 hours. Naturally I am also getting additional fluids through my meals.

    The wound care nurses appear to be off over the weekend, but they generally make the rounds on Monday.

    Is it typical to perform the bowel care routine in an inactive Clinitron? I have had no problems thus far but the incident with my ankle does provoke concern.

  6. #6
    Junior Member
    Join Date
    Feb 2017
    Location
    Canonsburg, PA
    Posts
    25
    I am a 46 year old C7 complete 23 years post injury. I've had three flap surgeries done over the past ten years and used a Clinitron for recovery after all three with success. I'm 6'-4" so you're a bit taller than I am but we run into the same issues with bed length. If they won't give you the boot I would suggest at least putting a pillow between your feet and the edge of the bed to prevent pressure. It's also possible that you got the sore from the bed itself. The pressure relief at the perimeter of the bed is not as good as it is in the middle. There just isn't as much circulation at the edges and being as tall as you are, that may have caused the sore. I've done the same thing to myself. You just need to be vigilant about protecting your heels and ankles even though you're still in a Clinitron.

    As was mentioned in the above posts, keep your protein levels up to help promote healing. Also, even though you're on a Clinitron it wouldn't hurt to turn periodically from side to side, as much as is acceptable, to redistribute the pressure. I did my bowel routine in the inactive Clinitron as well without issues just try to ensure that you are not resting on the wound site while the bed is off during your bowel regime and you should be good.

    I would also like to mention that once you are released to be cautious in what you do. Even though the wound is closed, the site doesn't have the strength of new skin/tissue. It will take about two years for the site to recover to it's full capacity. I ran into this problem after my first flap by sleeping on an inadequate surface and the whole thing broke down within two weeks and I had to start over. I found that it's a bad idea to just transition right back to a bed surface that may have caused the issues in the first place and your body just isn't ready for it yet. I couldn't get my insurance to cover anything after my surgery. I ended up having to get a used Clinitron online for my use and recovery. Hopefully you get and have everything you need. However, if for any reason you don't let me know. Since going through my issues I've started a no-profit charitable organization that unused beds and other pressure relieving surfaces and, with the help of a specialized medical equipment company, refurbishes them and donates them back to patients in need in the hopes of preventing others from having to go through what I did. If you need anything, or require any assistance, feel free to contact me. I may be able to help out. Good luck.

  7. #7
    I am sure the power won't be lost again- soon but... the facility needs to have a plan for when/if the power goes out when someone is on Clinitron bed or other special bed. It is like lying on a hard sandy beach... i.e. more frequent turns, prevalon boots, gel mattress overly...
    And really difficult to judge how long a wound was there in SCI!
    CWO

  8. #8

    Out of Hospital

    I am home after a successful stay of 61 days. My incision healing was "beyond textbook" according to the plastic surgeon and I had many days of showing it to groups of people, some of whom took photos.

    I only hope my ass doesn't end up on Facebook!

    Perhaps because I'm a non-smoking, non-drinking vegetarian my wound healing was better than usual. I don't know. I do know that it is mind-numbing to spend 6 weeks flat on your back.

    By the way, the reason I developed a pressure ulcer was due, partially, to my height. At 6'7" I take up so much room that my feet rest very close to the edge of the "Skytron" tub. Since my ankles were resting very close to the perimeter of the bed they did not receive as much pressure relief as anticipated. I was discharged yesterday with clear, blemish-free skin, so the problem was promptly addressed.

    The VA also addressed the power outages and they were corrected.


    Quote Originally Posted by SCI-Nurse View Post
    I am sure the power won't be lost again- soon but... the facility needs to have a plan for when/if the power goes out when someone is on Clinitron bed or other special bed. It is like lying on a hard sandy beach... i.e. more frequent turns, prevalon boots, gel mattress overly...
    And really difficult to judge how long a wound was there in SCI!
    CWO

  9. #9
    Quote Originally Posted by MartyDavis View Post
    I am home after a successful stay of 61 days. My incision healing was "beyond textbook" according to the plastic surgeon and I had many days of showing it to groups of people, some of whom took photos.

    I only hope my ass doesn't end up on Facebook!

    Perhaps because I'm a non-smoking, non-drinking vegetarian my wound healing was better than usual. I don't know. I do know that it is mind-numbing to spend 6 weeks flat on your back.

    By the way, the reason I developed a pressure ulcer was due, partially, to my height. At 6'7" I take up so much room that my feet rest very close to the edge of the "Skytron" tub. Since my ankles were resting very close to the perimeter of the bed they did not receive as much pressure relief as anticipated. I was discharged yesterday with clear, blemish-free skin, so the problem was promptly addressed.

    The VA also addressed the power outages and they were corrected.
    Glad you are all healed up!
    As a vegetarian, what are your main sources of protein?

  10. #10
    Glad to hear about the resolution of your wounds. You are right about the edges of those clinitron mattress/beds

    pbr

Similar Threads

  1. Pressure ulcer
    By quadmarie in forum Care
    Replies: 4
    Last Post: 02-08-2016, 09:36 AM
  2. pressure ulcer
    By pacera1117 in forum Care
    Replies: 2
    Last Post: 01-30-2016, 08:03 PM
  3. clinitron and pressure
    By J/L in forum Care
    Replies: 3
    Last Post: 09-24-2009, 11:26 PM
  4. Pressure Ulcer
    By EcaynoT in forum Care
    Replies: 3
    Last Post: 02-19-2008, 08:53 PM
  5. Replies: 0
    Last Post: 08-06-2001, 12:57 AM

Posting Permissions

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