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Thread: Managing/living with a pressure sore rather than healing...

  1. #11
    Quote Originally Posted by triumph View Post
    I have significant scoliosis for which I have always worn a brace. Not SCI, but I have a chronic bottom sore spot on one side which occasionally progresses to a blister (in spite of regular pressure relief). At those times my doctor recommended I spend more time lying down. About 3 days later the painful blister would go away. Last time I used a product I had never seen, a "blister band-aid", applied for 3 days, which immediately lessened pain and although sitting as usual, the blister disappeared. This Band-Aid has a cushion to it somewhat like the product Duoderm. Almost like a second skin.

    Since I have a lot of concern about where this is heading, I am soon to be seen for a wheelchair seating evaluation. I am hopeful they can recommend some kind of customized cushion for someone with pressure mainly on one side, and hopefully prevent any blister from forming. I am very active and in my chair 12+ hours a day.
    The constant worry like you mention is very much a part of the problem.

    I'm lucky that my scoliosis is no longer an issue for me since the surgery. I have a small curve still which does affect my seating a little but nobody has flagged this ad a major cause for concern.

    When I first got my vicair vector, it was set up with the little air cells placed to compensate for my wonky posture. What cushion do you use now?

  2. #12
    Junior Member
    Join Date
    Feb 2017
    Location
    Canonsburg, PA
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    27
    I use a ROHO Hybrid Elite. It is an air cushion under the sitting areas and "rigid" contoured foam under the legs to provide stability. Probably the best cushion I've ever used.

    I tried the theory of just trying to live with the sores but in every instance they inevitably deteriorated to stage 4 and I got osteomyelitis at which point its 6 weeks of antibiotics to clear the infection before I could even think about recovery or surgery. In the end I was just prolonging the inevitable. I'm of the opinion that it's better to treat is as soon as possible and get it taken care of. I'm not sure exactly what the root cause of your problems are but my issues were caused by poor sleeping surfaces. Somewhere along the line you're not getting the proper pressure relief you need, whether its in your chair or your bed is hard to say but you should investigate both.

  3. #13
    Quote Originally Posted by jdellovade View Post
    I use a ROHO Hybrid Elite. It is an air cushion under the sitting areas and "rigid" contoured foam under the legs to provide stability. Probably the best cushion I've ever used.

    I tried the theory of just trying to live with the sores but in every instance they inevitably deteriorated to stage 4 and I got osteomyelitis at which point its 6 weeks of antibiotics to clear the infection before I could even think about recovery or surgery. In the end I was just prolonging the inevitable. I'm of the opinion that it's better to treat is as soon as possible and get it taken care of. I'm not sure exactly what the root cause of your problems are but my issues were caused by poor sleeping surfaces. Somewhere along the line you're not getting the proper pressure relief you need, whether its in your chair or your bed is hard to say but you should investigate both.
    Stability was the issue when I tested the roho so I will write down the model that you use on my list of things to mention at my appointment. It's never been mentioned to me before, I was only offered either a regular roho or the vicair academy vector.

    I have zero pressure on the area in bed. With how the sore is presently (it's varied in severity over the years) I heal up entirely within a week of bed rest. Luckily I don't have any other areas of concern and can spend a whole night on one side without any marks. I know there's people who would pay good money to have a wound this small. But it just will not stay healed. The tissue Viability specialist described it as superficial. I would only live with it up to a point as I do experience pain, spasms and the sweats once a wound gets to a certain severity.

    Maybe a scan will reveal something. And i think it would definitely be beneficial to at least try other cushion options.

    Thanks for the replies.

    Sorry for all the rambling too, this is just a very emotive subject for me at the moment!

  4. #14
    Another cushion option to consider is the Jay Fusion - rigid foam for stability in front and then under the sitz bones/ITs either a pouch of gel or a section of roho. I've got both the Roho Hybrid and the Jay Fusion and I like them both. They're not interchangeable - I use them on different chairs.

  5. #15
    I have been looking at the roho hybrid and see that it is listed as medium risk whereas my current vicair is listed as high risk. Are these just general guides that depend on the individual? My only high risk area is my right sitting bone.

  6. #16
    Junior Member
    Join Date
    Feb 2017
    Location
    Canonsburg, PA
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    27
    I would regard those as generalizations at best. There's no telling where those rating came from or what they are based on. Talk with your therapist and doctor and get pressure mapped with both options and see what works best for you.

  7. #17
    Thanks jdellovade. Although my current cushion did not reveal any pressure areas during my last mapping, it does seem wise to investigate other options as the vicair has indeed been a constant all these years.

  8. #18
    In response to your question, I'm currently using a Ride Design cushion (not custom one), but I have had to add a 1' piece of cushion the same size underneath it. The cushion cover itself has about 1/4" cushioning in it.
    However, I am hoping the seating evaluation next month will come up with something better.
    I find I am changing cushions about every 3 months or so at the times when one becomes so uncomfortable that pressure relief doesn't help much. I'm guessing that cushions begin to flatten a bit with the constant sitting, and I keep about 3 or 4 on hand - over the past 10 years.

  9. #19
    Have you considered a Roho Quattro? I've got a recurring mark on right IT/sitting bone, it can recover but I think is now mainly scar tissue so goes pink. The tissue viability nurse and my spinal nurse suggested that cushion as it can be adjusted in 4 quadrants to balance out my posture. I was pressure mapped with it and whilst not significantly better than my Roho Smartcheck it did give a more even pressure distribution. I don't know how it works with only one air valve and a locking valve but does seem to be better, I'm back to being up 8-10 hours a day 2 weeks after I got it and was only up 4 hours a day. The mark is small, 1 cm diameter and like you I considered just sitting on it and seeing what happened but I am glad I didn't as am now making real progress.

  10. #20
    With the vicair cushion, it is essentially a new cushion regularly I guess, for as soon as any of the air pyramids flatten you can replace them.. when you check it anyway.

    As for the roho, I'm not sure which I tried but it wasn't stable enough for my needs but I am open to trying it again, plus any others.

    When I spoke to my spinal consultant about all of this, she offered the suggestion of a flap surgery as an alternative to constantly going on bedrest (agreeing that so many years of this means that it's time to try something new). I'm not sure how I feel about this. On here now looking at what others have experienced. If it ultimately improved my quality of life then great but if it was not a success then I think I'd feel angry that I opted to go down that route. Going to find out more from a plastic surgeon and whether this is a favourable option or not

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