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Thread: Ischial 4-stage pressure sores

  1. #1
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    Ischial 4-stage pressure sores

    I've got a few questions regarding my issues with pressure sores. I have been recently diagnosed with osteomyelitis in both of my ischial tuberosities. There was deep tissue culture done from both of my wounds because of me getting slightly feverish (they scraped the bottom of the wounds). The left wound appeared to be clean but there was Staphylococcus aureus (MSSA) in the right one. I've been taking amoxicillin orally for 2 weeks now and there is no change in my condition. I am still getting fever (around 100F). Can all these issues be from my bones? The problem is my ischials are covered with tissue so it's not possible to scrape the bone directly. Is it possible that there is another bacteria in the bone? I know the flap is the option here and getting rid of changed elements of the bone surgically but I'm scheduled for flap in 3.5 months. For now my dressings are changed three times a week in sterile technique by a surgeon in a wound clinic.

  2. #2
    I kind of went thru what you are now. Without getting into detail, I suggest they do a catscan to ensure you don't have any abscesses underneath. They didn't for me and it took two major flaps and a third stay in hosp. from the abscess finally almost killing me. For me ,it wasn't the wound so much as when the infection took hold and started to travel to my femoral artery.
    Last edited by Patrick Madsen; 04-08-2018 at 02:19 PM.

  3. #3
    Yes a CT scan will look at the extent of bone involvement; a MRI will look at the extent of soft tissue involvement. The biopsy will tell you the bacteria type. It is possible that the amoxicillin you are on is to keep the symptoms qwelled while you are waiting to have surgery. surgery is needed to get ride of as much of the bacteria in your bone as possible. You will need to be on IV antibiotics post surgery to match the bacteria identified. The key after surgery is to not re-ignite the bacteria causing the osteomyelitis. Try not to traumatize the area repeatedly. Do weight shifts, get a therapeutic cushion to take the weight off those sitting bones, stay free of infection.

    Best of luck with your your upcoming treatments.

    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.

  4. #4
    Senior Member lynnifer's Avatar
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    Why are they not administering IV-antibiotics?
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  5. #5
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    Quote Originally Posted by lynnifer View Post
    Why are they not administering IV-antibiotics?
    It requires hospitalization which I don't want. Today I'm going to have another culture done and maybe they will replace amoxicillin with something that will work. I just hope to stay in good shape till my flap surgery. Don't want to get some hospital infection in my urinary tract just before the surgery.

  6. #6
    Is it sensitive to amoxicillin? probably not. Need IV vancomycin for minimally 6 weeks- until crp and sedrate gpo back to normal. even with no symptoms you need the medicine for the osteo.
    CWO
    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.

  7. #7
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    I was said there is no need of bone biopsy as the tissue covering ITs isn't thick so it's sufficient to scrape the tissue just over ITs as the bone seeds bacteria to the tissue in the near area. I had another culture done, this time from different places because there was cloudy exudate in one of the pockets in the wound on my left butt cheek. I'll have results in a few days. Now I'm taking amoxicillin along with levofloxacin based on the previous culture.



    Quote Originally Posted by SCI-Nurse View Post
    Is it sensitive to amoxicillin? probably not. Need IV vancomycin for minimally 6 weeks- until crp and sedrate gpo back to normal. even with no symptoms you need the medicine for the osteo.
    CWO
    Why vancomycin? It's MSSA, not MRSA, so there are less toxic antibiotics than vancomycin. I was told by a surgeon who will do the flap that there's no need of antibiotics unless I get feverish. I'm supposed to take antibiotics a week before the surgery and then for a few weeks postoperatively.

  8. #8
    That is great that it is MSSA. We see a lot of MRSA!
    CWO
    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.

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