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Thread: Stage IV (4) Pressure Sore/Ulcer and KCI Wound Vac

  1. #11
    Moderator Obieone's Avatar
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    The alternating pressure low air loss bed has been a godsend 611 although it didn't prevent him getting a sore on his heel ..... but his ankles are an ongoing issue for him just like Lynnifer. Sometimes even when you do everything apparently correct stuff still happens ......
    Prevention prevention prevention .... bottom line .....

    Obieone
    Last edited by Obieone; 01-19-2008 at 10:12 AM.
    ~ Be the change you wish to see in the world ~ Mahatma Gandi


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  2. #12
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    Ok, a show of hands, how many people reading this thread just did a pressure relief, just b/c of what they read!

    (me for 1)
    T7-8 since Feb 2005

  3. #13
    I have a stage 4 on my left ischium myself that's been driving me nuts. General rule of thumb is if there's any bone exposed, it's more likely infected than not and there's no way you're sore will heal if you have any osteomyelitis. Most plastic surgeons when doing a flap surgery will grind down the infected bone to eliminate the infection. Also, most pressure sores start at the bone and work their way out, that's why it suddenly appeared as a hole. You need to stay completely off of it. It's a major struggle that I'm going through myself but a necessary evil for it to heal. I would definitely go for the flap surgery though if I were you. I'm going to get mine as soon as my body is ready for it.
    C-5/6, 7-9-2000
    Scottsdale, AZ

    Make the best out of today because yesterday is gone and tomorrow may never come. Nobody knows that better than those of us that have almost died from spinal cord injury.

  4. #14
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    re: pressure sore

    hi 3 years ago i had a stage 1 wound that after duaderm turned to stage 3--yes it made it worse. i saw a plastic surgeon who insisted on sitting on roho only and i had a wound vac. he told me after having just lost 50 pounds that i had to eat not just a high protein diet but also calories. i balked because i didn't want to gain weight back. he also told me to stay in bed until healed. when i finally followed his suggestions my wound began to heal. it took 2 1/2 months. but he was wrong about the roho. i actually have done very well with a gel cushion. my original wound was indirectly caused from the weight loss and sitting on my shower seat. i also got a new shower seat and have done pretty well. i had a slight relapse last summer, but by following the plastic dr.s recommendations it healed quickly----another thing a nurse suggested to me was to try skin prep on the wound it helps toughen the skin. i use stoma care pads because i also have a colostomy they really seem to help. i hope you heal soon. kathy

  5. #15
    Definitely staying off the area, keeping it clean and moist, and eating the right things helps. I would stay away from anything that is irritating to the skin- and that includes skin prep.
    CKF

  6. #16
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    Well this wound VAC does require patience. I was starting to doubt this machine, but after a week or so, the nurse noticed that the tunnels had filled in quite a bit. Furthermore, granulation tissue in the main cavity is coming together.

    I'm sure the wound vac plays a big role, but I'm also sleeping about 9-10 hours a day now (elavil), eating at least 100 grams of protein a day, multivitamins, lots of water, Juven, no coffee, no alcohol, no sweets, and maximum bed rest.

    I'm still not confident this thing will heal without surgery but I'm going to ride this formula as far as it'll take me. I also was able to get 5 weeks telecommuting.

  7. #17
    Senior Member Broknwing's Avatar
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    Glad to hear that the Wound Vac is working on your sore...Keep doing what you're doing and hopefully it'll continue to heal well...Congrats on getting your employer to work with you on the telecommuting...Hopefully he/she will be willing to extend those 5 weeks if necesary, when that time comes...Keep us updated. I know how much of a PITA these things are...It gets so frustrating and can get depressing at times....Make sure you've got things to keep you entertained and people visiting as well...it gets lonely even with family around...
    'Chelle
    L-1 inc 11/24/03

    "My Give-a-Damn's Busted"......

  8. #18
    Hi there,
    Apprecite your comment on KCI wound vac...I've only had it (on my stomach) for a week but home care nurse claims progress already...I am experiancing MUCHO pain at wound site..both everytime the vac comes on, (set on "alternating"), and when I move around. Is this normal would you know?
    Also, don't understand 2nd paragraph of your post...what do you mean by "stay off of it" after you say never turn it off? Thks for your help!! Sure appreciate it.
    Rob

  9. #19
    I would also consider being seen by a PT or OT and get pressure mapped. It sounds like you have had some ulcers, and the question is why. The answer may lie in the cushion you sit on, your transfers, shower seat, anything causing a shearing force such as dragging your butt up in bed, across a car seat , and if you use a power wheelchair and have a recline function, nutrition, lack of sensation and a multitude of other forces.
    But a simple assessment inclusive of pressure mapping, obsersation of your transfer skills, may prevent future decubs. According to the latest and greatest research they are now recommending that a pressure relief is every 15 minutes for a solid 2 minutes in order to allow for thorough capillary refill in the area of pressure. Seems like a lot, but as you can see some people have to go to any lengths to prevent pressure, or prevent any other kind of insult.
    Take Care,
    Pam

  10. #20
    I am having near exactly the same situation. I am nearing the one year mark with my latest wound, same spot as yours from the sounds of it. I am now at the point of wanting the surgery they are suggesting. I tried the wound vac for about 2-3 months and had nothing but problems with it. You definitely want to stay off of it more than you have been. I know how hard that is because I was in the same boat as you in the beginning. I would stay off of it as much as possible, at least for me I was staying off of it more than usual. It wasn't until about 2 months ago that one of the wc nurses told me that she had heard from a doctor that he tells his patients when they are at this stage that they are only allowed up for a maximum of 20 min a day three times a day. Man, I wish they would have told me that in the beginning! Whoever said that the nurses are trying to be sympathetic and just suggest that you stay off of it as much as possible rather than giving you actual parameters is so right! My sore is getting a bit better since following those guidelines along with a high protein diet, etc but there just hasn't been any real significant improvement. The tunnel started off at about 6 cm when they finally discovered that part of it and it has only gotten down to about 4.2 over the last 6 months. Most of that improvement was with the wound vac, but then it got static and my plastic surgeon said it wasn't really doing what he hoped it would do.

    My question for all of you out there is when do you say enough is enough and go ahead with a flap surgery? I really wanted to avoid it if possible, but I would like to get back to my normal life too! This bedrest is starting to get to me and I have only been doing it consistently for about 3-4 months. My family needs me and I need my life back. It's the stupid tunnel that just won't fill in. Any other suggestions I can try? I am using a roho type cushion, alternating air cushion, high protein diet and going to wc once a week.

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