Freaking tunneling wound!

[ging1218]

So, a few weeks ago, I noticed an odd center in the middle of husbands wound. (He has a shearing wound in the very center of his butt crack that has healed and come back for the past three years). Otherwise, it's a shearing wound that is mainly a surface wound. We went to a plastic surgeon ("specializing in sci") and he said I was doing a great job cleaning it and that there wasn't anything to worry about. Just stay off it. so my husband tried to stay off it... I went out of town for a couple of days and come back to a very dark, almost black, center with 1.5cm of tunneling underneath! WTF???!!! I am so upset. It also oozed infection and stank.
Here's what I did. Overnight, used Dakins as wet to dry solution. Then this morning, packed the tunneling w/ aquacel ag and covered with polymem foam dressing.
Questions: Should I try and remove the dead looking skin around the tunneling? Someone suggested Iodosorb. Anyone think that would help?
PLEASE HELP ME>>> Any suggestions for wound care sincerely appreciated.
PS- Our doctor sucks and we can't get in to see the physiatrist until october. there is a wound nurse at the hospital. but she only sees you if you're in the hospital... I did email her and she usually responds.
Thanks...

***Side note of irritation*** husband "had to go to the effing post office this morning. NO I can't go for him. He had to. He's being an ass and I'm feeling up to my eyeballs with taking better care of him than he takes care of his self.! RARRRRGH!

[SCIfor55yrs.]

I think you have done the right stuff. It probably should be debrieded, preferably by a wound doc. However, if you do not have access to one you trust, you may do a better job. If it stinks, it is likely infected. A wound center would probably have a plug biopsy done and culture it. A course of oral antibiotics might be indicated. I would also be concerned that the tunneling may be the result of an underlying osteomyelitis.

As for your husband's screwed up priorities, I suggest you get out your rolling pin and apply it forcefully to the side of his head. It might pound some sense into it.

[flicka]

I suggest you buy some Vetericyn spray (same formula as product used on humans, only cheaper). It will clean out dead tissue and get rid of infection.

[SCI-Nurse]

Hi,
If you have black covering, it is dead tissue called eschar and the Dakins soslution should help debride. For the tunnelling, the aquacell is a good product and if the draiange if alot then th foam will help absorb. Sounds like you are doing the right thing.\I would not suggest you remove the skin around as the wet to dry should do that on its own. If it needs further debridement, I would see the wound specialist.

I would give this current regime a few weeks, along with keeping all pressure off, eating a healthy diet with protein. If you notice more pus, fever, or other changes that go along with an infection, I would be seen by your doctor right away. Also, if when you put the aquacell in, you feel bone, I would see the wound nurse or your doctor right away.

I am not familiar with the vetericyn mentioned above.

AAD

[Leila]

I am not familiar with the vetericyn mentioned above.

AAD

Nurse AAD: If you are interested, Vetericyn is the veterinary version of Microcyn. They are the same product but many people prefer to use the Vetericyn because it is less expensive. Vetericyn/Microcyn is basically stable nSOS, or neutral super-oxidised solution. It has been around since the early 90s, first used extensively in Japan. It is produced by running an electric current through salt water, which polarizes the solution into negative and positive constituents. These two are then combined into a thrid solution, nSOS, n meaning Ph neutral (close to 7). The healing, antimicrobial and anti-inflammatory properties of nSOS were soon recongized, but the solution was highly unstable, denaturing in under 30 minutes. What Oculus Innovative Sciences did was tweak the combining process through an elaborate system of filters, coming up with a very stable nSOS with a stated shelf life of one year. Actually, it's now known to be more like two to four years.

At this point there are nearly 1000 doctors in the United States currently using or trialing Microcyn. It is becoming popular in many other countries as well. It is called Dermacyn in Europe and Oxum in India. China is now beginning to market Microcyn technology. More countries are listed on the site map: http://www.oculusis.com/us/sitemap There is also a lot of info there, including peer reviewed published studies.

MIcrocyn has cleared the FDA for a wide spectrum of wound and skin care applications, the latest being the hydrogel for burn clinics and negative pressure wound therapy. There are more clearances coming on a regular basis.

These four links are mostly short videos presented by doctors using Microcyn (plus one audio and three conferences):

http://www.youtube.com/watch?v=sAiWWNCfYH4

http://www.youtube.com/watch?v=O2saruj3qvQv

http://www.youtube.com/watch?v=3b0gp2C8R5E

http://www.oculusis.com/mexico/mp/video.php

This link features an article about a trial done in a nursing home about bedsores:

http://oculusis.com/dialogue/?p=103

For the record, I do not work for Oculus, nor do I own any stock in their company. I'm just one of many enthusiastic advocates.