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Thread: Questions about upcoming wound flap surgery of right ischium

  1. #1

    Questions about upcoming wound flap surgery of right ischium

    I have rotational skin flap surgery scheduled in March to repair stage 4 wound on the right ischium. I'm told it will be about 3 days in hospital and then to rehab center for a few weeks. Is a Clinitron bed the best choice after surgery and in rehab, or is there another option? Not sure yet what type of bed the rehab will have. Does medicare cover a Clinitron bed in home? I have an alternating air pressure mattress at home; is this sufficient?
    Any pros or cons re the clinitron vs the air mattress?

    What would be a realistic time in bed before sitting protocol is started, assuming there are no complications?

    Also have concerns about bowel regime (using suppositories & manual disempaction) in bed after surgery and keeping the wound clean. Anyone have experience with this issue?

    Thanks, any input would be greatly appreciated.

  2. #2
    Clinitrons are a brand of air fluidized bed. This is the best bed for recovery from a flap. We kept our flap patients on an air fluidized bed for 5 weeks minimum, and then for another week of bedrest on a low air loss (not an alternating pressure overlay) before starting sitting, and used a low air loss mattress for a total of 6 months post op. So no sitting for 6 weeks post-op.

    You do manual removal, not "disimpaction", for normal bowel care (unless you are actually impacted). Don't use that term or the nurses will be reluctant to do this procedure for you. The nursing staff should do your bowel care for at least the first 3 weeks post-op to be sure that they don't contaminate the wound. A transparent dressing (like OpSite) can be placed over the incision/dressing to keep the wound protected during bowel care.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  3. #3
    Quote Originally Posted by Quickie View Post
    I have rotational skin flap surgery scheduled in March to repair stage 4 wound on the right ischium. I'm told it will be about 3 days in hospital and then to rehab center for a few weeks. Is a Clinitron bed the best choice after surgery and in rehab, or is there another option? Not sure yet what type of bed the rehab will have. Does medicare cover a Clinitron bed in home? I have an alternating air pressure mattress at home; is this sufficient?
    Any pros or cons re the clinitron vs the air mattress?

    What would be a realistic time in bed before sitting protocol is started, assuming there are no complications?

    Also have concerns about bowel regime (using suppositories & manual disempaction) in bed after surgery and keeping the wound clean. Anyone have experience with this issue?

    Thanks, any input would be greatly appreciated.
    Hi Quickie,

    I'm just finishing up my second flap this year (at the tail end of my seating protocol). You should absolutely make sure they have a Clinitron bed. Those things are gold standard and will prevent any pressure issues post flap. I started my seating protocol at week 6 like SCI-Nurse mentioned. I can send you the seating protocol chart I have and you can print it out for your plastics team to see if they want to use it.

    I was actually able to continue using the IryPump and irrigating my bowels every other day while in bed with a system of bed chux and a fracture pan. I would lay on my side opposite from the flap and do my thing. I wouldn't worry about the bowel program, it sucks doing it in a bed and with another individual helping you out if you're not used to that, but it's very doable.

    You're in for a long haul, but I hope it's smooth sailing. Let me know if you want my protocol.

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