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Thread: Pressure Injury Treatment with E. coli UTI and Possible Findings of Something Deeper

  1. #1

    Pressure Injury Treatment with E. coli UTI and Possible Findings of Something Deeper

    I have a long-term pressure injury and, while our treatment protocol(s) seem to be making the injury shrink, it still is persistent and has not shown signs of healing in over three months. To make matters worse, I have had Klebsiella (which I was hospitalized for) and now E. coli UTIs for straight more over three months now. The wound care expert at the hospital provided me with Santyl and told me to continue with the course of treatment.

    My question is if there is a deeper, underlying cause of these continuous UTIs and long-term pressure injury?

    I came across this article from the University of Washington website:

    Spring 2002: Volume 11, Number 1

    New Findings in Pressure Ulcer Prevention and Treatment

    http://sci.washington.edu/info/newsl...vent_ulcer.asp

    Does anyone know if there is anything more recent? Will my current UTI causing issues or false readings when testing for a catabolic state?

    Would love to hear your war stories and/or any advice before I speak with my doctor on Monday.

    Have a great weekend!

  2. #2
    It is not uncommon to seed bacteria back and forth from an colonized or infected bladder or kidney and a pressure injury. Has your wound been investigated for underlying osteomyelitis? This can carry blood born bacteria to your kidney fairly easily.

    Santyl is an old drug (ointment) used for debridement of necrotic (dead) tissue in a pressure injury. It may work, although sharp debridement (cutting out the dead tissue) is usually more effective and quicker. Who are you seeing for your wound management? Have you been evaluated by a plastic surgeon who is expert in management of deep pressure ulcers in people with SCI/D? Have you been evaluated for osteomyelitis? Have you had blood levels of CRP, sed rate, and WBCs done?

    I assume you are staying completely off this wound surface?

    (KLD)
    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.

  3. #3
    Wound treatment was at the hospital. Since then, I've had my nurse's aid follow the procedure. Currently I am seeing no one for wound management; I have not been seen or evaluated by a plastic surgeon; haven't been evaluated for osteomyelitis; nor have I had blood levels checked for any of that. My primary care physician is not mentioned anything regarding the questions you've asked. Although, she was the one that made me wait a whole week before sending my results to the urologist who immediately sent me to the hospital for the Klebsiella infection. My only courses of action at this time are the Santyl and Amoxicillin Clavulanate for the UTI which was sent from my urologist. The wound specialist at the hospital asked for a surgical consult, but was told they chose not to go forward with debridement. I do not know why.

  4. #4
    Suggest you ask your primary care physician to refer you to a wound care clinic where these tests can be done, and which has a plastic surgeon who can consult on surgical management of your pressure injury.

    (KLD)
    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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