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Will this sacral wound EVER go away?! (Graphic Pic Warning)

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    So thought I would post an update.

    Since I last posted, my doc did a MAJOR debride that made my others look like nothing more than scraping the surface. Basically 3/4th of the edges were totally scar tissue and tough as can be. He thoughts were that if he could get it down to soft fatty tissue it may respond to the VAC. Of course this would mean the wound would have to become bigger. He did it in a way where he kind of beveled the edges inward. Then he said, "I want to do Apligraf on you." This excited me since flap surgery is not an option for me. So basically, upon going back the next week (which was this last Thursday) first of all for the first time the dimensions of my wound had shown the first sign of improvement. The 1st round of Apligraf was applied (after another wound cleaning of course). My wound vac is still being used, but of course on a lower setting of 125mmHg. Monday will be my first vac change, I can't wait to see it. Then I will go Thursday for another graft. At this point, we just want it sealed off. So I pray the grafting "takes"... I also have been ritually taking the Pro-Stat AWC daily.


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      Karen M
      C 3/4 inc. central cord
      10/29/1992 - 18 years, but who counts?


        Chlorophyll soft gels, and Hawaiian sprilina. I use them daily for infection reduction/immune builder- as an alternative to vit C. Used to get frequent uti's. Beenpretty clear since starting these suppliments. Good luck!
        "People Will Forget What You've Said, They'll Forget What You've did, but They'll Never Forget How You Made Them Feel" -Maya Angelou


          The 1st apligraf didn't take. Applied 2nd one today, this time we have taken off the wound vac. I also for the first time has a low air loss overlay that was delivered today. Hope all this helps. I am happy to be off the vac to be frank as I do not believe it has helped me at all.


            total agreement

            Originally posted by SCI-Nurse View Post
            The photo is not very sharp, but it does appear that you have a serious stage III or IV pressure ulcer. It is very unlikely to heal without surgery from the tale you told above. Of course you should not be sitting at all, ever, no matter what wound treatment is being used. You should be on a low air loss bed. A memory foam mattress does not provide enough pressure reduction to help a wound heal.

            I agree with the plastic surgeon that you probably need a flap. With proper care, you would not get pneumonia just from being on bed rest. People with high spinal cord injuries are also at risk for pneumonia and DVT on bedrest, and are often difficult to intubate for surgery, but they have these surgeries all the time.

            How is your nutrition? What is your pre-albumin level? Your CRP level? Are you taking protein supplements? A multivitamin?

            Unless you're going to a doctor's visit you should not be setting up an you need a pressure relieving mattress preferably low air loss. You also need to seriously increase your protein levels I would suggest a casein protein, you can get it it GNC it comes in 2 pound bags and with the GNC card is less than $40. If you get your hormone levels checked it's possible that you can get an anabolic steroid to help you with your wound healing but that's something I would definitely consult with your doctor about I have a serious wound 1000 times worse than yours so everything I'm telling you is from almost 2 years of experience. Get back to me if you'd like to know more
            Mark Twain: Truth is stranger than fiction, but it is because Fiction is obliged to stick to possibilities; Truth isn't"

            What is gone before is gone. All you have now are the results of your actions.

            Anti--Intellectualism is been a constant thread winding its way through our political and cultural life, nurtured by the false notionthat democracy means that my ignorance is just as good as your knowledge - Isaac Asimov


              Misty and spouse, I really do appreciate your predicament. I had a wound from a back surgery open up. The wound opening was a bit smaller than a nerf football, but you could out the football in the space, had an infection, and was on steroids and antiinflamatory drugs, thus it "popped" at home, wife and dtr could see my spine.
              Wound doc said it was gonna take awhile and it did. I was 16 months on the wound vac, and she would scrape it whenever it needed it(scare tissue was forming). Was a pain in the back, but it did close up with surgery, and been good since(except a fusion surgery that went awry, and I ended up in chair.)
              Any way, point is, take your time, and it will close up hey I had sudimonus 4 times and MRSA twice, and other stuff infections, and we just treated em all. Hand in their, you'll get better.


                Unfortunatelu, each person heals at their own rate for a lot of different reasons. I would suggest that you increase your fluid intake, your calorie intake and your protein intake. The wound loses a lot of fluid and protein and it takes a lot of calories to heal. I would also recommend the VVF - it has helped a lot of people and maybe something that works for you. Stay off of it as much as possible (I know -easier said than done.)

                ANd hang in there. It does take a lot longer for a wound to heal conservatively versus with surgery. I do understand why you are going the route that you are - just pointing out the issues.
                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.


                  I soooo feel what you are going through. Been there, done all that! Apligraf was a complete failure for me. After 3 different applications and about 20 grand charged to my insurance I was worse off than ever. I just dont believe those are made for open pressure wounds of any depth or size.

                  I would really really consider the flap surgery by a plastic surgeon that is well versed in pressure wound care. You will be back to yourself within weeks.


                    Yes protien, protien, hated cottage cheese, but ate it and lots of salmon too, and yougurt to balance the tummy.


                      Are you on any antibiotics? It might help to speed up the healing, if you get the right one on board. I speak from years of experience, both personal and professional.
                      Hope this helps.
                      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.


                        I just had a nasty pressure wound that looked that way. I used Santyl during the day and Medihoney at night. With a soft gauze. Is this a juicy wound or dry? Sounds juicy to me. Santyl could work great but is expensive.


                          So in response to everyone. I appreciate everyones advice! I have done all of the above... I have been on the Pro-Stat AWC for a good while now, even though ALL of my nutrition levels are excellent without it. Couldn't hurt right? I have done Santyl out the wazoo and medi-honey as well. I would consider this wound moderately juicy. On the vac over a week there would maybe be a couple of tablespoons of drainage.

                          So... I have new news...

                          First of all... I finally got a LAL. I am blessed because I work for Apple and don't have to deal with Medicare anymore. My work insurance is AWESOME. Second of all... I am on my 4th Apligraf and when I had the 2nd on applied... it WORKED! For the first time I had significant granulation buds. So then on the 3rd one... it was even BETTER! In fact there was even some hyper granulation on one side (which they were NOT fussing over). My wound doc is ecstatic!! As well as I... so since the first failed apligraf... the rest have shown progress. I went from 1.8cm depth, to 1.3, to 0.9 now! I go back Thursday for a check, and will get my last one. Then he will move me on to Dermagraft (you get 8 applications of that) and hope it will fill it in even more. I have been off the vac and we don't disturb the dressing for a full week until its changed in the office. The drainage isn't too bad at all. I am certain the LAL played the biggest role in this. Might I add I am sleeping SO much better on it. So yeah... as of right now I am healing. I have to take sponge baths which kind of suck, and I go to the beauty salon up the street twice a week to wash my hair. But I am NOT complaining!