Anyone ever deal with pressure sore in this area?

[dpatrick]

So I?ve been dealing with this pressure sore for months now,it?s between the scrotum and rectum. They don?t think it is pressure from coccyx or ischials.
it started I think from shearing as my butt tends to slide over to the right and I try pushing up and sliding my butt back over.i use a high profile Roho.was superficial in beginning.
the wound is now .5mm x .6mm x .7 mm depth.i go to wound care 1 x week.
i am going to wound care,they are cleaning it with vashe,then inserting Bout a 4” piece of this stuff called cutimed sorbact(.they were using prisma ag for bout 6 weeks before that) ,covering with a piece of mepilex then clear tegaderm. They used Isidorb for few weeks before the prisma ag.
It gets changed every 2 days by rn.
I haven?t been off it as much as I should.i have been laying down 3-4 hrs earlier during week,and off most weekends lately..I?ve been totally off it for 4 days now..usually up 11 hr day before all this,,lately up 6-7 hr a day.
ive never dealt much with a would in this area..
when I get out of w/chair,my pants are a little wet from a clear seepage that comes from rectum,that has been going on for awhile..I?m not sure what causes that but it?s probably irritating to skin..any ideas for some kind of protectant in this area?
or ideas on a wound treatment for the sore that others have used?
Thanks everyone.

[pfcs49]

I think your measurements are off by at least one decimal point. For example, 6mm=1/4"; .6mm=25 thousands of an inch.
My hunch is they're supposed to be CM? If they were, it would mean wound is in the 1/4" realm. That would be wonderful!
Mine was more in the 5CM realm, so ~2"x2.3" x2.7" which would suck!

Good luck whatever the case! I had the same wound location in 2012 after 20 years with no problems. I soon ended up getting flap surgery and ~2months in a Clinitron bed in our kitchen area.

PS: I hunch it's not your rectum that's leaking. More likely is the damn wound, especially if it's 5CM.

[nick]

I've had one there as well....... in close proximity as well. Was rather large at 4cm, 3cm.

First off, let me say... insist they swab this sore and culture to see what bacteria is present. I learned this from a 47 year para who lives right down the road. I was on an antibiotic for a few weeks and then finally had great regranulation with the tissue.

Increase your protein, and drink a lot of water. Water helps carry red blood cells, promotes healing.

If it's infected, it's not going to heal at all, or fast enough. It may not even look infected to you, or that wound nurse, but being so close to the anus, it'll be!

Also, I understand the nurse is the "pro" here at your wound clinic, but advocate for yourself and tell them you don't want bandages and creams being flipped around like you're a science experiment.

Doing that just prolongs the situation. Give a cream, honey, bandage, whatever several days, weeks.... to get a result happening. Progress forward, don't let it stall out.

I used a bandage that could be left on for 48 hours, and some santyl (prescription only, makes a bright red wound bed for growth) was applied, after Vashe was used.
Stuck on a Allevyn Life 6x6 bandage. They work the best IMO. Absorb well and the bandage edges (adhesive) flex with your movement. They may even make a bandage to form that area. Ask the wound clinic.

I also just recently got a new Roho where I had the cells in the problem area knocked down to only 1/2" height the entire area around it is 4". I use a Quatro High Profile. I was also pressure mapped at a clinic, being sure the new cushion idea would work. After 3 different PT's said it was a bad idea.... I have proven them wrong.

Like I said, advocate hard for yourself.... they're not always right!

[dpatrick]

Your right,it is mm..so 7 mm depth.

[dpatrick]

I’m going to wound care tomm so I’ll ask to have a culture to see if bacteria there,good idea..they say it looks clean but I’ll ask them that.

did you mean use medi honey?ive heard of that,works great,eh?
last nite rn put some of the new stuff in it,they have been using for a week now,called cutimed sorbact,they cut bout a 4” piece and put it inside and leave a little out,,rn said last nite she wasn’t crazy bout it,thinks it may do more harm than good have to gently push it in..I’ll talk to wound care bout it took..
i was using the alley now and still have few boxes..they had me switch to the mepilex and cover with tegaderm,,comes off though after shower so they put new piece on..thanks much

[SCI-Nurse]

First of all- over time, you do need to change the type of dressing being used depending on the wound's response. I do agree that you need to stick to one treatment for a few days, provided that you are not getting worse from it. Changing treatments is not making you a science project. However, that being said, I would ask the rationale for the change and what is the goal for the next week.

You need to stay off of the area. I can not stress that enough. Adding pressure to an already weakened area is just asking for trouble. That means no sitting!

I agree that you need to look at your nutrition and fluid intake. Make sure that you are getting enough protein in your diet and enough good calories. It takes both to heal.

I don't think it is a bad idea to get a culture, but make sure that they don't take it from the top of the wound. Everyone has bacteria on the surface. The culture needs to come from deeper in the wound.

Hope that this helps.

ckf

[pfcs49]

a photo at next wound care would be helpful here.

[crags]

I once had a rectal fistula which leaked pinkish fluid and wasn't so easy to see. I take it this has been eliminated? It had to be opened up and then packed. Mine healed okay and that was over 25 years ago.