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Thread: Heal a wound over tunneling?

  1. #31
    Quote Originally Posted by Tim C. View Post
    I have had nothing but success with my three- 4th stage decubiti, using a " forward thinking" plastic surgeon who made her bones in would care. Can't say enough about her. She has offices in LI and Staten Is.
    PM me and I will forward you info.
    Regards & best
    Thank you. He was hoping for a little more north than that, but if he changes his mind, I will let you know.

  2. #32
    Quote Originally Posted by SCI-Nurse View Post
    Did the doctor biopsy the bone? Interventional Radiology can bx it and antibiotics can be started from that. Might be a repeat of before. When he stopped the antibioitcs di the sedrate go down and the CRP or still elevated?

    CWO
    Yes, there was osteomylitis and a piece of the bone was removed and he had a picc line. He is off the antibiotics and has been for several months now. The mri in Februrary suggested that there may be a hint if the Osteomylitits still there, but it was not followed up on. His sed rate was still not within normal range when the picc line was removed, but did drop down quite a lot. His last sed rate was in the 60s. After the picc line was removed, there has been no follow up blood work. He did ask, but was told it was not necessary unless he had symptoms. The nausea, fever, chills and fatigue have gone away, but he still has a lot of sweating at night. This is not normal for him. He has never sweated at all below his injury since his accident many years ago.

  3. #33
    Senior Member McDuff's Avatar
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    Gotcha, I misread a bit about the measurements. From what I know, you do *not* want the skin to close over a tunnel. When this started with mine, the Doc debrieded(sp?) the wound open again, it needed to heal "up" before it can heal over or bad things happen.

    Quote Originally Posted by Sugarcube View Post
    I agree there has been no improvement on the depth but the outside has been closing around it. Now the skin has started and almost completely covered the top. There is a small pinhole left, which is basically how this whole thing started. I'm concerned that the cavities below will eventually fill up with fluid again, become infected and some time in the next several weeks or so he will be septic again. I think he needs to get a referral in order to get the flap. I doubt he will get that from this doctor. The depth has been measured on a weekly basis from visiting nurses. Four days prior to it being measured a 2.5 cm, it was 5.5. The other tunnel, which showed on the mri in Feb has not been treated at all, I guess because it is not an open wound yet.
    "a T10, who'd Rather be ridin'; than rollin'"

  4. #34
    Quote Originally Posted by McDuff View Post
    Sounds to me like the Doc missed the tunnel on that last measurement, don't think there's anyway for things to heal up that quickly. If you've been trying to heal this for a year, think it's time to throw in the towel and get a flap. Yeah, it sucks having to lay flat for 5-6 weeks, but, it's a known entity, when it's over it's over. As you well know, y'all been on a wound treadmill for far too long, with no end in sight. I took the known entity for sure. I had a buddy bring up my Xbox and I played the time away, the tv was mounted high so I could play easily with just a little head raise.

    I'm in Tx so can't help with facility. But I definitely suggest to "not" cancel the plastics Doc appt, at least get his opinion. Just remember a surgeon "likes" to cut.

    McDuff.. Hubby facing bone removal surgery for Osteomyelitis and then flap surgery. How long ago did you have surgery and is everything going well now? Just trying to prepare for what is to come...a little nervous to be honest any info is appreciated.

  5. #35
    Quote Originally Posted by Sugarcube View Post
    Yes, there was osteomylitis and a piece of the bone was removed and he had a picc line. He is off the antibiotics and has been for several months now. The mri in Februrary suggested that there may be a hint if the Osteomylitits still there, but it was not followed up on. His sed rate was still not within normal range when the picc line was removed, but did drop down quite a lot. His last sed rate was in the 60s. After the picc line was removed, there has been no follow up blood work. He did ask, but was told it was not necessary unless he had symptoms. The nausea, fever, chills and fatigue have gone away, but he still has a lot of sweating at night. This is not normal for him. He has never sweated at all below his injury since his accident many years ago.
    Sugarcube, has your friend seen any improvement? It seems these pressure sores are really difficult to understand and treat. Hope your friend is making some progress.

  6. #36
    Senior Member McDuff's Avatar
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    Hey Aspen, I just replied in your other thread before I saw this. I have had a couple of flaps now, , the one with osteo was a few years ago now.

    As for how things are going, I am always fighting my butt skin, it's the bane of my existence. But the flaps have held up fine. Make sure it's a Plastics Doc who does the surgery, and has done plenty, they will do whatever scraping may need done during the flap surgery, so it's only one time deal.

    One thing; there will be the timeframe for removing the sutures while he is in rehab unit. Have them remove them at the earliest possible time. I had another wound "explode" on me a year after the flap surgery, we found an inch of leftover suture down in the wound. If they wait too long, the suture can/will break when they try to cut and remove the pieces, as it has adhered to your body. Be there when they are going to do it so you can watch, I obviously couldn't see what they were doing.

    I don't want to worry you, my experiences with flaps have been wholeheartedly positive, they have given me my life back. If y'all have been battling this for a long time with no end in sight, this will at least give you an end date, which is much easier to bare. And even though flap skin is supposed to be more fragile, I have not had any issues with those areas.

    Ask away if I can help with anything else.
    "a T10, who'd Rather be ridin'; than rollin'"

  7. #37
    The MRI will always show chronic osteomyletic changes- as long as it is not acute it should be ok.
    I don't understand how the tunnel can not be an open wound. The tunnel has to be healed first before it totally closes.
    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.

  8. #38
    Quote Originally Posted by Aspen View Post
    Sugarcube, has your friend seen any improvement? It seems these pressure sores are really difficult to understand and treat. Hope your friend is making some progress.
    Thanks for asking. The doctor at the 2nd wound clinic decided to let it heal over the top, despite our continuous objections and uncertainties about the tunneling underneath. They did not think a follow up mri was necessary to confirm the complete closure. So my friend made an appointment with a plastic surgeon, who reluctantly agreed to the mri, thankfully so. The mri report said that there was a superficially healed fistula/abcess on his "issue him." It literally said that, "issue him." It must have been a typo that clearly was supposed to say "ischium," but he had a chuckle over that. There is also a small cyst near the bone that is filled with fluid. The cyst is contained but transcends up the entire fistula/tunnel. So, to answer your question, he has some improvement but, like your husband, is scheduled for a muscle flap procedure. Please keep us posted about your husband. I hope all goes well for him. We are here if you need us. My best wishes and thoughts are with you both.

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