Pressure Sore that won't stay closed post surgery?

jmoyn2339 · 07-14-2012, 10:59 PM

Hi,
I was wounder if the CareCure group could advise me on a very troubling medical situation that I am dealing with. I have a pressure sore on my butt that I had to have closed surgically. The surgery was done in January 2012 and currently(July, 2012) I am only able to sit up in my wheelchair 1-2 times a week for about 2 hours. When I sit up the wound gets very red and is developing fluid bubbles and when the bubbles start to drain the would opens and usually takes about 2-3 weeks to close up. Then I'm back to the starting point with the wound.

I had a follow up appointment with the surgeon and he didn't seem too interested in evaluating what is wrong. He actually said the wound looks good and when I explained the drainage and wound opening situation his response was stay in bed. I guess it;s easier to tell someone to stay in bed for the rest of their life than to diagnose the problem.
Does anyone have any suggestions as to how I should handle this matter?

Thanks

smokey · 07-14-2012, 11:52 PM

First of all you should find another surgeon to give you a second opinion. Second, I would suspect the wound is infected. Third, maybe you need to have the ischium bone shaved down a little and that is causing pressure. Why do I say this? It sounds eerily similar to my situation about a year ago.
In Nov. 2010 I had a plastic surgeon close a small, clean and shallow wound on my ischium. It never looked right afterwards. It was red, weeping, stitches were crawling out of the incision and it split open 2 weeks after I came home. He blew me off and said my situation was now a "seating issue that was causing the problem". I went to another surgeon who dd an MRI to check for osteomyelitis . It was negative but at least he checked. Anyway, he ended up doing a second excision in Nov. 2011 and little flap surgery, shaved down the ischium and found a "sinus tract" in the wound. He also found some staph in the wound and put me on antibiotics for a month. So here I am 9 months later and I seem to be doing OK. I do "baby" the wound and do weight shifts and pressure reliefs more than ever.
I hope you can find some answers because I know exactly what you are going through.

SCI-Nurse · 07-14-2012, 11:53 PM

This is unfortunate. I would recommend returning to your primary care provider and provide your health history. A MRI to look at the soft tissue below the surface of the skin would reveal any possible issues.

pbr

jmoyn2339 · 07-15-2012, 01:56 AM

Thanks Smokey and pbr for your quick and helpful responses.

I think having a second opinion is a great suggestion. As you mentioned that your wound was in the ischium area as mine is and I will be following your advise.

I am in the NYC area and wanted to ask if either of you know of a good surgeon in the NYC area that you can suggest?

Thank you for you help.

lynnifer · 07-15-2012, 02:33 AM

Quote:

Originally Posted by jmoyn2339

... when I explained the drainage and wound opening situation his response was stay in bed. I guess it;s easier to tell someone to stay in bed for the rest of their life than to diagnose the problem ...

I have had this said to me as well. Very frustrating. The above advice covers it.

What cushion are you on? Any special mattress in your bed? Any bodily function accidents that would weaken the skin or dragging over a tire?

takenaback · 07-15-2012, 04:22 AM

Quote:

Originally Posted by jmoyn2339

Hi,
I am only able to sit up in my wheelchair 1-2 times a week for about 2 hours. When I sit up the wound gets very red and is developing fluid bubbles and when the bubbles start to drain the would opens and usually takes about 2-3 weeks to close up. Then I'm back to the starting point with the wound.
Thanks

So you're sitting on a surgically closed wound 1-2 times a week and after you do this it takes 2-3 weeks to close up? You're surprised by this? Sitting on any wound can do damage fast as is evidenced by your statement.

Are you sure your doctor wasn't telling you to stay in bed until the wound is healed rather than the rest of your life?

You may well be right that there is something sinister going on and I understand it is a pain in the arse literally for you and I don't want to sound too harsh but you won't heal a serious wound by sitting on it.

I sincerely wish you quick healing so you can get up in your chair permanently.

SCIfor55yrs. · 07-15-2012, 01:57 PM

I am left wondering if your wound really is healed or just closing over. I think a second opinion is a good idea, but only if the surgeon is experienced with pressure sores. Most have little or no knowledge and experience with our problems. I would suggest you look for a wound clinic to do an evaluation. They often have better expertise available, especially for non-surgical solutions.. When you are looking, ask very directly how many SCIs they treat.

What was the cause of your wound in the first place and have you eliminated it? If it was due to inadequate seating and you have not resolved the problem, you are not going to get anywhere.

smashms · 07-15-2012, 05:50 PM

i know a great plastic surgeon in the albany area if you are interested. his name is Ashit Patel he is at albany medical center. he closed my wound up in march granted i still have an area still open but i also had stiches that opened up after surgery while in the hospital that he did not want to close. over all it has been a good expierence and would recommend him.

Donno · 07-15-2012, 05:52 PM

Quote:

Originally Posted by takenaback

So you're sitting on a surgically closed wound 1-2 times a week and after you do this it takes 2-3 weeks to close up? You're surprised by this? Sitting on any wound can do damage fast as is evidenced by your statement.

Are you sure your doctor wasn't telling you to stay in bed until the wound is healed rather than the rest of your life?

You may well be right that there is something sinister going on and I understand it is a pain in the arse literally for you and I don't want to sound too harsh but you won't heal a serious wound by sitting on it.

I think you need to re-read the OP. He never said that he was sitting on an open wound. "The surgery was done in January 2012 and currently(July, 2012) I am only able to sit up in my wheelchair 1-2 times a week for about 2 hours. When I sit up the wound gets very red and is developing fluid bubbles and when the bubbles start to drain the would opens and usually takes about 2-3 weeks to close up. Then I'm back to the starting point with the wound."

jmoyn2339 · 07-15-2012, 10:06 PM

Hi lynnifer,
I was using a Jay deep contour until the would developed. Two weeks after I had the surgery the hospital transferred me to their SCI rehab unit and while in the rehab unit I was pressure mapped and they determined that the Jay wasn't working for me so they switched me to a ROHO.

07-14-2012, 10:59 PM	#1
jmoyn2339 Junior Member Join Date: May 2005 Location: Yonkers, NY Posts: 16	Pressure Sore that won't stay closed post surgery? Hi, I was wounder if the CareCure group could advise me on a very troubling medical situation that I am dealing with. I have a pressure sore on my butt that I had to have closed surgically. The surgery was done in January 2012 and currently(July, 2012) I am only able to sit up in my wheelchair 1-2 times a week for about 2 hours. When I sit up the wound gets very red and is developing fluid bubbles and when the bubbles start to drain the would opens and usually takes about 2-3 weeks to close up. Then I'm back to the starting point with the wound. I had a follow up appointment with the surgeon and he didn't seem too interested in evaluating what is wrong. He actually said the wound looks good and when I explained the drainage and wound opening situation his response was stay in bed. I guess it;s easier to tell someone to stay in bed for the rest of their life than to diagnose the problem. Does anyone have any suggestions as to how I should handle this matter? Thanks

07-15-2012, 01:57 PM	#7
SCIfor55yrs. Senior Member Join Date: Mar 2009 Location: Columbia, SC Posts: 5,243	I am left wondering if your wound really is healed or just closing over. I think a second opinion is a good idea, but only if the surgeon is experienced with pressure sores. Most have little or no knowledge and experience with our problems. I would suggest you look for a wound clinic to do an evaluation. They often have better expertise available, especially for non-surgical solutions.. When you are looking, ask very directly how many SCIs they treat. What was the cause of your wound in the first place and have you eliminated it? If it was due to inadequate seating and you have not resolved the problem, you are not going to get anywhere. __________________ "S.O.S. = Save our Shoulders" (click link) See me at: http://cccforum55.freehostia.com/

07-15-2012, 05:50 PM	#8
smashms Senior Member Join Date: Jun 2011 Location: New York Posts: 2,053	i know a great plastic surgeon in the albany area if you are interested. his name is Ashit Patel he is at albany medical center. he closed my wound up in march granted i still have an area still open but i also had stiches that opened up after surgery while in the hospital that he did not want to close. over all it has been a good expierence and would recommend him. __________________ T6 incomplete due to MS and aortic aneurysm surgery that went bad.

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07-14-2012, 11:52 PM	#2
smokey Senior Member Join Date: Jul 2001 Location: Massachusetts, USA Posts: 1,865	First of all you should find another surgeon to give you a second opinion. Second, I would suspect the wound is infected. Third, maybe you need to have the ischium bone shaved down a little and that is causing pressure. Why do I say this? It sounds eerily similar to my situation about a year ago. In Nov. 2010 I had a plastic surgeon close a small, clean and shallow wound on my ischium. It never looked right afterwards. It was red, weeping, stitches were crawling out of the incision and it split open 2 weeks after I came home. He blew me off and said my situation was now a "seating issue that was causing the problem". I went to another surgeon who dd an MRI to check for osteomyelitis . It was negative but at least he checked. Anyway, he ended up doing a second excision in Nov. 2011 and little flap surgery, shaved down the ischium and found a "sinus tract" in the wound. He also found some staph in the wound and put me on antibiotics for a month. So here I am 9 months later and I seem to be doing OK. I do "baby" the wound and do weight shifts and pressure reliefs more than ever. I hope you can find some answers because I know exactly what you are going through.

07-14-2012, 11:53 PM	#3
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,341	This is unfortunate. I would recommend returning to your primary care provider and provide your health history. A MRI to look at the soft tissue below the surface of the skin would reveal any possible issues. pbr

07-15-2012, 01:56 AM	#4
jmoyn2339 Junior Member Join Date: May 2005 Location: Yonkers, NY Posts: 16	Thanks Smokey and pbr for your quick and helpful responses. I think having a second opinion is a great suggestion. As you mentioned that your wound was in the ischium area as mine is and I will be following your advise. I am in the NYC area and wanted to ask if either of you know of a good surgeon in the NYC area that you can suggest? Thank you for you help.

07-15-2012, 10:06 PM	#10
jmoyn2339 Junior Member Join Date: May 2005 Location: Yonkers, NY Posts: 16	Hi lynnifer, I was using a Jay deep contour until the would developed. Two weeks after I had the surgery the hospital transferred me to their SCI rehab unit and while in the rehab unit I was pressure mapped and they determined that the Jay wasn't working for me so they switched me to a ROHO.