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Same butt wound for over a year, any advice???

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  • Same butt wound for over a year, any advice???

    In the hospital over a year ago (during the rehab for his injury), my husband (para t7-8 complete) got a tear right above his butthole. It's in the crack and will not heal. It'll get better, then he'll rip it back open. We've seen home health but they've discharged him due to no progress. I'm using silver foam everyday. I have to change the wound dressing usually twice a day because it's in such a bad spot. He's too active to stay off of it. He can't feel it at all (or he wouldn't be able to sit). I am at a loss. We do not have a wound care specialist in my town. Any advice (besides the obvious stay off of it... you try to tell him)?

  • #2
    drink alot of protein. go 1 gram per pd of his body weight.
    Bike-on.com rep
    John@bike-on.com
    c4/5 inc funtioning c6. 28 yrs post.
    sponsored handcycle racer

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    • #3
      I've actually been checking out protein shakes... he's diabetic too though. thanks, we'll up the protein. We have done that in the past andit does seem to help.

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      • #4
        The coccyx area is the most difficult to heal because of the natural 'top 'o da crack' .. lol. I had success with surgical intervention and that was twenty years ago - still holding strong.

        Have you seen a plastic surgeon who's done a flap?

        Diet is so important. Do you have access to electrical stimulation?
        Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

        T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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        • #5
          Originally posted by ging1218
          I've actually been checking out protein shakes... he's diabetic too though. thanks, we'll up the protein. We have done that in the past andit does seem to help.
          try bsn syntha 6
          Bike-on.com rep
          John@bike-on.com
          c4/5 inc funtioning c6. 28 yrs post.
          sponsored handcycle racer

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          • #6
            Hi,

            A consultation with a plastic surgeon may be beneficial.
            I have seen silver help healing but foam is designed for draining wounds and if it is not draining alot, it should not require changing twice daily. Once every 1-2 days unless the dressing is heavily draining. (refer to product recommendations).

            AAD
            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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            • #7
              Another thing I thought of: Check his transfers. Just my opinion, but wounds like that in that area might be caused by a 'slack' transfer where he's scrapping the bummeroonie on the wheel or brake.
              Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

              T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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              • #8
                Thanks as always. We are upping the protein. He is certainly not careful enough when he transfers and he's not boosting as often as he should. but an AMAZING thing happened today... there is a wound care nurse in this town and I found her. there's just not a clinic and none of our dr. knew about her. She's at the hospital and we see her on Monday... I can't wait, I hope she's magic.

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                • #9
                  Interesting ...

                  Let me get this in perspective. What is more important to him: Being active? A pressure sore for over a year? Or his health over all?

                  Being active with an open pressure sore? Is that a smart thing to do?

                  Hmmm ...? Makes me think?

                  Didn't Christpher Reeve die from a pressure sore that got infected that lead to his death? He was active too.

                  What would a wound care specialist tell him? Stay off his butt till it heals?

                  How much do you love your husband? Take his 'chair away from until it gets healed.

                  That's only my opinion.


                  titanium4motion
                  "We must overcome difficulties rather than being overcome by difficulties."

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                  • #10
                    Originally posted by ging1218
                    Thanks as always. We are upping the protein. He is certainly not careful enough when he transfers and he's not boosting as often as he should. but an AMAZING thing happened today... there is a wound care nurse in this town and I found her. there's just not a clinic and none of our dr. knew about her. She's at the hospital and we see her on Monday... I can't wait, I hope she's magic.
                    I really can't tell him to stay out of his chair until it heals, because I didn;t for the longest time. But if he isn"t staying off it he absolutely MUST be doing pressure reliefs very very frequently! He is really in denial here about what it will take to heal this. And be sure he is on a good cushion, Get it pressure mapped if you haven;t and if it is at all possible.

                    I;m afraid that you will find that the wound care nurse IS magic, and her magic will be bedrest.

                    (Mine finally did heal, when the plastic syrgeon I was sent to put his foot down. 2 months of bed rest, getting up only for the bathroom and doctors appointments. And I was lucky it was that quick.)

                    Sorry to sound mean about it.
                    T7-8 since Feb 2005

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                    • #11
                      You know, i read this 5 min after you posted and was gonna respond, typed up a post, but all i had to say was stay off it, i decided not to post... But as everyone here has said the same, I'll do it now too...
                      I healed 3 major sores.. 2 ischials... either side of left bone, and a sacrial sore naturally by staying off them for 3 1/2 yrs... Yes thats 3 1/2 shity years.

                      By what you say, i bet 1 to 2 months of limited activity would finish it off. Then extreme care in transfers for a few more would take care of the stregthening.

                      I've seen my share of wound nurses, and unless you stay off it, you don't stay on their service long. My nurse fought for me for whatever she needed cause I did stay off, and in the end everything is healed.

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                      • #12
                        Ok..ok..you guys are preaching to the choir. I know all of this to be true. I'm the one who spends hours researching his injury and reading this awesome forum. The LAST thing I want to be is an enabler. I can't really take the chair away since I'm at work and he's home all day but I get the point. I'm sure the nurse will emphasize the importance of staying off of it and then may be he will listen...

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                        • #13
                          Leave the chair; just take one wheel off. ;-)
                          Oh, be nice and leave him a glass of water, fluids are important too.

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                          • #14
                            I gashed a big hole in my tailbone just above the crack as I fell 110 feet. I hit a few rock outcroppings on the way down, same thing happened with the back of my head, but at least that healed. to this day, the gash on my coccyx hasn't completely healed, and that's 22 years ago....

                            I also acquired a pressure sore on my butt two years ago, and although it's closed and healed, it's still red and angry after a long day. I doubt either will fully heal, unless I stay in bed. But I just can't do that, I'd go more bugeyed crazy than I already am.

                            Best of luck ging1218
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                            Thanks!

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                            • #15
                              with it being a sacrum wound, there's not going to be as much pressure on it when he sating compared to when he's lying in bed on his back. When you sit in the chair, all of your weight is on your ischium's and when you're lying down your tailbone digs down causing more pressure. When he's in bed, either have him on his side or put pillows under his knees to elevate his knees and get the pressure off his sacrum. People, don't forget how uncomfortable it was to lay flat on the floor where your tailbone is
                              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.

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