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Thread: recurring pressure ulcer

  1. #1
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    recurring pressure ulcer

    Hi All,

    Been a T5 paraplegic 15yrs and had my first pressure sore 3yrs ago to my left buttock around the ischial area, I have a Brachial Plexus injury to my right arm as well so i'm not a over active wheelchair user but I am up and in it everyday without fail, the sore got to the ulcer stage with skin broken around 3.5cm and after only 2 weeks total bedrest it fully healed but my problem is after getting back in my chair 3 - 6 months down the line it came back in the exact same area. My main cushion I used for 10yrs before the first sore was the J2 after changed to a Invacare flotech solution x which again was ok for around 6 months then pressure sore came back and again 2 weeks total bedrest healed. The last 5 months ive been using a Vicair cushion with the air cells which again looked like it was doing the job till yeah a week ago i'm back in bed a pressure sore exact same spot as always.

    I am looking at the Roho Quadtro cushion to have next but I feel now whatever cushion I use its gonna be just a matter of time till I get my next sore.


    So please any help would be appreciated.

  2. #2
    You may have a ischial bone that is anatomically uneven to the other and hopefully with the cushions you've tried your trunk balance has been addressed. additionally with the recurrence you should get ruled out whether you have a bone infection present in that IT.

    pbr
    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
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    Thanks for the reply, hopefully I'm having an MRI done in the next few weeks to see if their is any underlying problems but I've been thinking if my sliding/transfer board is causing the problem as I use it everytime I transfer out my chair, because my right arm is paralysed as well I'm actually sliding 'not lifting' my whole body weight along the board so I'm thinking is it shearing what's causing it I've been doing it that way from day one of my injuries. I really like to try and be independent and do things for myself unless its having to be transfered by hoist and I don't want it to come to that yet.

  4. #4
    I am old (like dirt old), butt is abused and wore out. I've taken to wearing Mepilex border, 4x4's or 6x6's as an added protection, when I see the slightest redness. I wear one 2-3 days then check it. The glue does not seem to bother my skin, this may be different for you. I think your movement may be shearing your skin, cause it sounds just like what I get. I've had problems with about every cushion because of that. Now I rotate between a roho quatro, and stimulite.

  5. #5
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    Hi,

    How do you find using a sliding board with the roho Quattro cushion?

    Also I've been thinking 'mind you I've been doing a lot of thinking stuck in this bed' that if my pressure ulcer is from shearing wouldn't it start by showing a red area on my skin! As when my ulcer starts its like a very little red spot like you would have on your back or face. Because my Carer has said to me in the past 'you have a little red pimple' tniking its just like acne but then it turns into the ulcer.

    Thanks.

  6. #6
    I don't use a sliding board. The Quatro might be good, because the four chambers make the front much firmer than the back. I can feel the difference when I push up on it compared to other ROHO's.
    I would have your carer take pics of your butt. Best way to keep track of what's changeing. If its pimple like, it could be from heat/sweat. Its probably hard to do lifts with one arm.
    I also wear compression bike shorts, that are slippery. To help with shear and use antiperspirant, to help with sweat.

  7. #7
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    After 2 weeks in bed the pressure ulcer healed my nurse said to get up in your chair for 2hrs max, so after 2hrs sitting in my chair I relieved the pressure off that area every 15mins got back on bed my Carer checked my butt and to my worst nightmare bright angry red and some dark area of bruising. I'm devastated what the f**k is going on! The other butt cheek nothing at all not a mark!

  8. #8
    Need to change something. First don't sit 2 hours, more like 20 minutes and then pressure relief. After an hour get off your butt and take a pic. ANY redness needs to be addressed. That's the way we use to fit ski boots. So as soon as any redness you need to fix the cushion. Do you sit straight? Also try something slippery (satin pillow case, etc) on the surface you transfer.
    At least its not broken skin. Hang in there.

  9. #9
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    Thanks,

    I do sit quite good being a T5 paraplegic but with my right arm and shoulder being paralysed (brachial plexus) im wondering if it's anything to do with that because the pressure sore is that side on my buttocks and my shoulder drops that side.
    I have got a hospital appointment end of month so hopefully they can tell me more what's wrong.

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