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Thread: MRI for pressure wound?

  1. #1
    Senior Member pixyvixen's Avatar
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    MRI for pressure wound?

    What conditions would prompt a doctor to recommend an MRI for a pressure wound? What kinds of things would they be looking for?

    fyi- this pressure wound is chronic and lately has had a "rare infection" treated with mega-antibiotics. Oh yeah and it's in the iscial region.

  2. #2
    An MRI can show the extent of the wound--how deep and wide under the surface it goes. It can also give some indication if there is an underlying bone infection (osteomyelitis).

    Rare infection? Tell more....

    RAB

  3. #3
    Senior Member pixyvixen's Avatar
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    If there's bone infection, what then? Hospital time? Intravenous antibiotics? Amputation?

    I'm not sure what kind of a rare infection it is... I'm kept in the dark about these things.

  4. #4
    The best way to deal with the pressure ulcer if there is a bone infection is to have a plastic surgery procedure called a myocutaneous rotation flap. The rotate health skin and muscle tissue after they cut out the bad tissue and chip away any infected bone. We're talking about six weeks with surgery and bedrest, so it's not trivial, but it works better and faster than trying to heal in the wound the old fashioned way.

    Unless you've had lot's of pressure ulcers treated with surgery in the same spot, we're not talking amputation. Some IV antibiotics would be part of surgery, but nothing long term.

    So the surgery is probably the best way to go, if you can have it.

    RAB

  5. #5
    Senior Member pixyvixen's Avatar
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    He's had about 8 flap surgeries in about as many years.... there's not much left to flap back there. "Skin and bones" as you'd say, but apparently not much skin either!

  6. #6
    pixyvixen - A MRI reveals changes in soft tissue that cannot be seen with an ordinary exray. It would give the doctor a better understanding of why this chronic skin ulcer is not healing. Has he had an infectious disease consult? This too should be an important part of finding correct management for a chronic ulcer.

    Has he had all pressure off of the ischial area? As KLD always notes, all pressure must be off of an area for it to heal. CRF

  7. #7
    Senior Member pixyvixen's Avatar
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    SCI Nurse,

    Yes, in fact his entire summer was spent off of the wound. It healed up pretty well over the summer, but then when school started again and he had to be up again, here came the wound again. Grrrr it's so frustrating! We'll look into the infectious disease consultation, though. Thank you so much for the information so far.

    xoxo Pixyvixen

  8. #8
    pixyvixen - Wow, that has got to be so frustrating...but there is some reason that the area either was not fully healed or that from the repeated flaps, etc., it is very vulnerable to diminished blood supply. Has he been to a good seating clinic that can do 'pressure mapping' to better determine the weight distribution over the chair cushion? Has his wheelchair cushion been changed and does he know for sure that he is properly fitted in his chair? CRF

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