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Thread: First pressure sore need answers

  1. #1
    Senior Member nevada's Avatar
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    First pressure sore need answers

    It finally happened after 14 years I have my first sore which I got back in November while I was in the hospital. I don't have a picture but I believe it is a stage two from what my wife tells me. She said it looks like it is about the size of nickel and not very deep. I have been using medihoney on it now for about three weeks and my wife thought that is was looking better during dressing changes. However the last two weeks or so it has started to weep for a lack of a better term. My wife said the dressing feels dry when she changes it but is sure the fluid is coming from the sore. She said the fluid that is coming from it is clear in color with a slight odor but not like rotting tissue smell. Thing is it is now weeping to the point of saturating my pants by noon. It does not bleed but just the clear fluid is all that is coming from it. Could it be the medihoney that is causing it? My wife said I should see a dermatologist but I don't think that would be the correct doctor and I really have no idea who to see. I know the hospital I was in when I got has what they called a skin nurse but I don't know more than that. From what I have read here I am guessing I should see a wound specialist but what type of doctor should I ask for to make the appointment as I do not see that option on their online appointment scheduling.

    Thanks in advance

    Nevada

  2. #2
    If your area has limited resources to specialists, a dermatologist could indeed make a preliminary diagnosis, prescribe initial treatment and refer you to a specialist. Many hospitals have a wound care clinic with wound care specialists to diagnose and treat pressure sores.

    See someone right away! Complicated pressure wounds rarely respond to home remedies.

    Are you staying off of the area completely? If not, get off and stay off of the area involved until you see a doctor. Make sure your diet is good and high in protein.
    Last edited by gjnl; 02-05-2017 at 12:26 AM.

  3. #3
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  4. #4
    Senior Member Donno's Avatar
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    I agree that you should see a wound specialist, but in the meantime, STAY OFF OF IT. I did just what you are doing for about 3 months. One day it went from a mostly surface wound to one that was 2 cm in diameter and about 1 cm deep. I saw a surgeon and he did a debreidment and put me on a Wound ac for 6 weeks. The wound was nearly closed, but wasn't healed at depth and I had to have flap surgery and stay in bed 9 more weeks.

    If you do a search for pressure sores on the forum, you will find that many of us have had the same or similar experience. Best of luck.
    Last edited by Donno; 02-05-2017 at 12:16 AM. Reason: spelling
    Don - Grad Student Emeritus
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  5. #5
    Recommendations
    -no pressure to area
    -medihoney absorbs into the wound and will debride the dead material from the wound- which is good
    -i would definitely recommend not using medihoney on an area where there is pressure (sitting on medihoney causes more problems from my past experience with patients)

    When there is dead material in a wound it will drain
    pressure externally (sitting) and internally (bone) are both factors at worsening the condition of a wound

    pbr

  6. #6
    Agree with all of the great advice above.

    If you already have a Family Practice or Internal Medicine doctor though, call their office as soon as they open tomorrow to explain the problem and, either make an appointment, or ask them to send an order for ASAP home evaluation and treatment to a wound care nurse. Most Primary Care Doctors have patients with non-healing leg wounds from diabetes and circulation problems. They'll know who to call.

  7. #7
    HI Nevada, I would recommend you see a plastic surgeon or consultant for proper treatment of your sore. Visit him as early as possible to prevent the sore getting worse into grade 3 or 4. Few years back, careless attitude on my part let me suffered grade 4 pressure sore and i had no other option left but to undergo flap surgery. As it 's your first sore, you should read this http://spinalinjury.info/pressure-so...rmation-sheet/ blogged by our forum member Asif.
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  8. #8
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    My stage IV healed really well – – like no one can tell used to be there – – staying off of it for months and eating a lot of pro – stat (horrible tasting liquid protein) and ensure. When I briefly had to sit, I covered it with a Mepilex (or so) bandage. I had regular 3am visits from the wound team at Kessler, and the would nurse watching it in subacute, but I don't recall anyone ever actually doing anything to it.
    Last edited by Random; 02-09-2017 at 09:53 PM.

  9. #9
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    I would definitely schedule an appointment with either a wound care center or a plastic surgeon. You should also stay off it as much as possible. Any time spent on it now is only going to exacerbate the problem. If it's not too bad yet, a topical treatment like a Mepilex dressing might help but the only way to heal it is stay off it altogether. While some may recommend it, using things like a wound vac won't solve your problem. Protein and pressure relief are your two best options. I'm a C7 complete 23 years post injury and have had three flap surgeries in the past ten years. You should also consider a adequate pressure relieving sleep surface both to help this sore heal and to prevent others in the mean time. It sounds like you are at the point now where you should be spending your days in a Clinitron bed to get this healed up. If it progresses any further you'll need a flap surgery and then it's several months of 24/7 bed rest. That's a path you want to avoid if you can.

    My biggest problems over the years was gaining access to the proper bed to help heal the sores. Insurance wouldn't cover the level of care needed. I bought a Clinitron online and now use that on a daily basis. After three flap surgeries I err on the side of caution anymore. After going through my trials and tribulations with obtaining the proper surfaces I've started a non-profit charitable organization that acquires used beds and other pressure relieving surfaces and refurbishes them to then donate them back to other patients who are in need but have barriers in obtaining the necessary equipment. I you think I may be of assistance to you, feel free to contact me and we can try to work something out. Good luck.

  10. #10
    I doubt it is a Stage 2 with what you describe. If you have necrotic tissue- white, yellow or dark slough- you can't really stage it. And Pressure ulcers start from the inside and what we see is the outside. So typically since from a bony surface pressure , they are typically deeper than you think. But as mentioned you should stay off of it. Also, increased fluid think infection and not healing-think osteomyelitis.Yes, you need to see w wound specialist!
    There are new guidelines out for PRESSURE INJURY!!!! that is the new term. google it.
    CWO

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