pressure sores

Josh · 07-24-2001, 12:30 PM

I was wondering what I should do about a skin breakdown on the base of my tailbone? It has been there for about a week and it's gotten a little bigger. I've been keeping it clean with soap and water, dry, and putting antibiotic on it. I go to the doctor tomorrow, again. I was just wondering if you all had any suggestions. This is my first one. Thanks, Josh

SCI-Nurse · 07-24-2001, 06:45 PM

Pressure ulcers in the coccyx are generally caused by one or more of the following:

*lying on your back too long
*sliding forward in your chair and sitting with a pelvic tilt
*allowing others to lift you by your pants or belt loops (major wedgie!!)

Pressure ulcers should be kept covered and moist if they are open...not dry. Clean only with water or normal saline...no soap. Do not use Betadine or Peroxide. A rule of thumb is never put anything on a pressure ulcer that you would not put in your eye.

A hydrocolloidal dressing such as Duoderm or Comfeel will often be easy to use here, and can be changed only every 1-2 days. Of course most important is to keep completely off the area, including no sitting at all until it is healed. The bone is very close to the surface here and a pressure ulcer in this area that is open goes quickly from a stage II (shallow) to a stage IV (down to the bone).

(KLD)

donna · 08-09-2001, 04:32 AM

I just went to the doctors at the beginning of the week, I have a pressure sore. The doctor had to clean it out he said it was at stage 2, but he told me to clean it with saline water and peroxide. Does this sound right? I have to do it twice a day.

SCI-Nurse · 08-09-2001, 09:37 AM

Of course you should not be sitting with this sore, or lying on your back at all in bed. Often this type of sore is made worse by slacks that are too tight, or someone assisting you with transfers by tugging on your pants or belt.

Peroxide should never be use on open wounds. Although it is a mild antiseptic, it will inhibit the growth of fibroblasts, which are the cells that make up scar tissue and allow the wound to close. Normal saline alone is best. If the wound drains pus, then you may need to use Dakins solution, although it does also somewhat inhibit fibroblast growth.

You should also place a saline moisted gauze in the wound (keep it off normal skin) and cover with a waterproof dressing to keep the wound moist at all times. Alternatively you can use a hydrocolloidal dressing such as Duoderm or Comfeel or Restore, and change this every other day. Cleaning twice daily is not needed if you do the latter. Do not scrub when cleaning...pat and rub gently.

Be sure you are eating a good balanced diet with emphasis on high protein, fruits high in Vitamin C and green leafy vegatables. Add a good multivitamin if you do not already take one. Ask your physician about taking a zinc supplement to aid wound healing. (KLD)

etexley · 08-10-2001, 04:06 PM

What about electrostimilation of the gluts to aid in circulation and promote healing?

Eric Texley

SCI-Nurse · 08-10-2001, 07:09 PM

Actually electrical stim to the wound itself is sometimes tried. We have used it at our center with varying result. It does require a specialized device that is fairly expensive, and at our center must be done by a PT who has special training. I don't know of any evidence that electrical stim to the gluteus would be helpful in actually healing a coccyx wound heal, although it probably would not be harmful. (KLD)

07-24-2001, 12:30 PM	#1
Josh Senior Member Join Date: Jul 2001 Location: Little Rock,AR Posts: 377	pressure sores I was wondering what I should do about a skin breakdown on the base of my tailbone? It has been there for about a week and it's gotten a little bigger. I've been keeping it clean with soap and water, dry, and putting antibiotic on it. I go to the doctor tomorrow, again. I was just wondering if you all had any suggestions. This is my first one. Thanks, Josh

07-24-2001, 06:45 PM	#2
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,345	Coccygeal sores Pressure ulcers in the coccyx are generally caused by one or more of the following: lying on your back too long sliding forward in your chair and sitting with a pelvic tilt *allowing others to lift you by your pants or belt loops (major wedgie!!) Pressure ulcers should be kept covered and moist if they are open...not dry. Clean only with water or normal saline...no soap. Do not use Betadine or Peroxide. A rule of thumb is never put anything on a pressure ulcer that you would not put in your eye. A hydrocolloidal dressing such as Duoderm or Comfeel will often be easy to use here, and can be changed only every 1-2 days. Of course most important is to keep completely off the area, including no sitting at all until it is healed. The bone is very close to the surface here and a pressure ulcer in this area that is open goes quickly from a stage II (shallow) to a stage IV (down to the bone). (KLD)

08-09-2001, 04:32 AM	#3
donna Junior Member Join Date: Aug 2001 Location: Clarksburg Posts: 1	Pressure sore I just went to the doctors at the beginning of the week, I have a pressure sore. The doctor had to clean it out he said it was at stage 2, but he told me to clean it with saline water and peroxide. Does this sound right? I have to do it twice a day.

08-09-2001, 09:37 AM	#4
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,345	Wound care Of course you should not be sitting with this sore, or lying on your back at all in bed. Often this type of sore is made worse by slacks that are too tight, or someone assisting you with transfers by tugging on your pants or belt. Peroxide should never be use on open wounds. Although it is a mild antiseptic, it will inhibit the growth of fibroblasts, which are the cells that make up scar tissue and allow the wound to close. Normal saline alone is best. If the wound drains pus, then you may need to use Dakins solution, although it does also somewhat inhibit fibroblast growth. You should also place a saline moisted gauze in the wound (keep it off normal skin) and cover with a waterproof dressing to keep the wound moist at all times. Alternatively you can use a hydrocolloidal dressing such as Duoderm or Comfeel or Restore, and change this every other day. Cleaning twice daily is not needed if you do the latter. Do not scrub when cleaning...pat and rub gently. Be sure you are eating a good balanced diet with emphasis on high protein, fruits high in Vitamin C and green leafy vegatables. Add a good multivitamin if you do not already take one. Ask your physician about taking a zinc supplement to aid wound healing. (KLD)

08-10-2001, 04:06 PM	#5
etexley Senior Member Join Date: Jul 2001 Location: Boca Raton, Florida, USA Posts: 1,446	??? What about electrostimilation of the gluts to aid in circulation and promote healing? Eric Texley

08-10-2001, 07:09 PM	#6
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,345	Electrical stim Actually electrical stim to the wound itself is sometimes tried. We have used it at our center with varying result. It does require a specialized device that is fairly expensive, and at our center must be done by a PT who has special training. I don't know of any evidence that electrical stim to the gluteus would be helpful in actually healing a coccyx wound heal, although it probably would not be harmful. (KLD)

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