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Thread: Who has had stage IV pressure sore

  1. #11
    Senior Member Tim C.'s Avatar
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    Quote Originally Posted by Smashms View Post
    1st step id debriding the wound and removing the infected bone and culturing the wound to see what antibiotics will work on it. next step is IV antibiotics for a few months then closure either by suturing it closed or by doing wet to dry dressings 2x a day.
    a few MONTHS of iv Antibios?
    wow, that not typo?

  2. #12
    Senior Member McDuff's Avatar
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    I had a 4 with osteo, I had a port put in and we did daily IV by using these pressurized little "rubber balls" that had the correct amount of antibiotic in them. Took about 1/2 hour for it to finish draining into the port. Cool little invention, allowed me to stay home and my wife hook me up. I was on it for quite a few weeks, don't remember exactly how long, sorry.

    After the course of antibiotics, it was flap surgery for me, and I was good with that. I had been fighting this sore for like 8-9 months and it wasn't getting better. At least with a flap, you know it is a 5-6 week stay, then you get to slowly get back to life again instead of bed-life.
    "a T10, who'd Rather be ridin'; than rollin'"

  3. #13
    No ortho surgeon, Interventional radiologist can bx. the bone. IV Antibiotic Treatment is recommended by Infectious Disease or PCP or SCI MD. minimally 6 weeks usually. Plastic Surgery does Skin flaps. Need to stay off till healed in special bed. then when healed sitting program needed to slowly increase time up in wheelchair.
    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.

  4. #14
    Quote Originally Posted by McDuff View Post
    I had a 4 with osteo, I had a port put in and we did daily IV by using these pressurized little "rubber balls" that had the correct amount of antibiotic in them. Took about 1/2 hour for it to finish draining into the port. Cool little invention, allowed me to stay home and my wife hook me up. I was on it for quite a few weeks, don't remember exactly how long, sorry.

    After the course of antibiotics, it was flap surgery for me, and I was good with that. I had been fighting this sore for like 8-9 months and it wasn't getting better. At least with a flap, you know it is a 5-6 week stay, then you get to slowly get back to life again instead of bed-life.
    I see your from dfw im also in this area,do you know any facilities that does pressure mapping?

  5. #15
    For wheelchair seating pressure mapping in your area of Texas, check out Baylor, Scott and White Institute for Rehabilitation. They have RESNA (Rehabilitation Engineering and Assistive Technology Society of North America) certified Assistive Technology Practitioners (ATPs) and their website mentions pressure mapping. https://www.bswrehab.com/levels-of-c...chair-seating/

  6. #16
    Quote Originally Posted by SCI-Nurse View Post
    No ortho surgeon, Interventional radiologist can bx. the bone. IV Antibiotic Treatment is recommended by Infectious Disease or PCP or SCI MD. minimally 6 weeks usually. Plastic Surgery does Skin flaps. Need to stay off till healed in special bed. then when healed sitting program needed to slowly increase time up in wheelchair.
    CWO
    The wound clinic suggested Infectious disease and ortho surgeon. We met with Ortho surgeon yesterday and he wants to cut out a piece of bone (ischium) and send for biopsy then have Infectious Disease doc recommend antibiotics ..go home with picc line.. then have plastics dr do flap. He said in perfect world it will heal in a month. Is there a better way? I have no idea what the best options is....we had 3 drs (PCP, Wound, and surgeon) tell us no other ortho surgeons in our area like to deal with Osteomyelitis because the success rate is so low. There was an X-ray done 5 weeks ago showed no abcess or osteomyelitis...MRI was done 3 weeks ago and showed osteomyelitis. So should we just go to a plastics dr not ortho? This is first ever pressure sore in 16 years...thanks for help.
    Last edited by Aspen; 06-19-2019 at 10:52 PM.

  7. #17
    Quote Originally Posted by McDuff View Post
    I had a 4 with osteo, I had a port put in and we did daily IV by using these pressurized little "rubber balls" that had the correct amount of antibiotic in them. Took about 1/2 hour for it to finish draining into the port. Cool little invention, allowed me to stay home and my wife hook me up. I was on it for quite a few weeks, don't remember exactly how long, sorry.

    After the course of antibiotics, it was flap surgery for me, and I was good with that. I had been fighting this sore for like 8-9 months and it wasn't getting better. At least with a flap, you know it is a 5-6 week stay, then you get to slowly get back to life again instead of bed-life.
    So did you have to have piece of bone removed or did they treat the osteomyelitis with just antibiotics? If bone removed was it your plastics doc who did it? This is why I am worried seems they are anxious to cut but if that is necessary...OK...just want to make sure its the best option. The dr did say the wound won't heal until Osteo gone.

  8. #18
    Quote Originally Posted by gjnl View Post
    For wheelchair seating pressure mapping in your area of Texas, check out Baylor, Scott and White Institute for Rehabilitation. They have RESNA (Rehabilitation Engineering and Assistive Technology Society of North America) certified Assistive Technology Practitioners (ATPs) and their website mentions pressure mapping. https://www.bswrehab.com/levels-of-c...chair-seating/
    Thank you

  9. #19
    Senior Member McDuff's Avatar
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    Quote Originally Posted by SLIQNES View Post
    I see your from dfw im also in this area,do you know any facilities that does pressure mapping?
    My last mapping was done by guys from National Seating & Mobility when I was in flap rehab. The Rep that did the mapping is in a chair but I forget his name. The Rep I worked with that arranged it is Casey Stephens, casey.stephens@nsm-seating.com , he is a good and knowledgable guy.
    "a T10, who'd Rather be ridin'; than rollin'"

  10. #20
    Senior Member McDuff's Avatar
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    Quote Originally Posted by Aspen View Post
    So did you have to have piece of bone removed or did they treat the osteomyelitis with just antibiotics? If bone removed was it your plastics doc who did it? This is why I am worried seems they are anxious to cut but if that is necessary...OK...just want to make sure its the best option. The dr did say the wound won't heal until Osteo gone.

    Yes, they scraped some bone off, no big piece they said, just the surface stuff that looked bad. It was done during my flap surgery and was not informed that there was any different surgeon there, and it was the Plastics Doc who informed me afterwards of what was done during surgery, so my "assumption" is that yes he did the bone scraping.

    For sure it won't heal until the osteo is gone. How you proceed after that is up to you. The Plastics Doc came and saw me in the Wound Clinic after the osteo was gone, and laid out my options in his opinion, he and I were in agreement that this wound was beyond healing. I was so tired of it by then, that having a true deadline was very appealing, as even trying to heal this was going to be *many* months with no promise of a different ending.

    I feel for y'all, these are "trying" things, and mind bending in the hassle of dealing with them.
    "a T10, who'd Rather be ridin'; than rollin'"

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