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Every week when I go to the wound clinic

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    Every week when I go to the wound clinic

    The Doctor scrapes out the pressure sore on my foot, it is taking forever to heal. Is it best just to not mess with it and let it heal? The Doctor claims you gotta get rid of the dead grass for the new grass to grow. I'm starting to wonder if I'd be better off just not going to the wound clinic and letting it heal on it's own?
    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

    #2
    Not sure how small your wound is, but shouldn't be a need for debridement more than every 4-6 weeks (just in my own experience). Try it for two weeks?
    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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      #3
      It seems to me that debridement every week will not only remove dead tissue, but also the delicate new granulation tissue that has developed since the last appointment - thus defeating the purpose. I agree with Lynnifer, you might consider spreading the appointments a little further apart and see if the wound starts healing faster.
      MS with cervical and thoracic cord lesions

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        #4
        Is this a real wound clinic, or a podiatrist office? Are they experienced in SCI pressure ulcer management, or do they do mostly diabetic foot ulcers? What treatment are you doing between these debridements?

        Sounds like a cash cow for this physician (doing a debridement gets him a much better insurance reimbursement than doing a wound check and dressing change only).

        How is your nutrition? What is your CRP? Your pre-albumin level? Have you been tested for possible osteomyelitis?

        (KLD)
        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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          #5
          Curt, I have trouble healing pressure sores on my ankle area and they will heal only with a cast, it keeps edema down and keeps the sores from any pressure. Still have to see the wound therapist weekly at first, later about 10 days or so. It still takes 3-4 months to heal a 18mm sore.

          Comment


            #6
            Originally posted by SCI-Nurse View Post
            Is this a real wound clinic, or a podiatrist office? Are they experienced in SCI pressure ulcer management, or do they do mostly diabetic foot ulcers? What treatment are you doing between these debridements?

            Sounds like a cash cow for this physician (doing a debridement gets him a much better insurance reimbursement than doing a wound check and dressing change only).

            How is your nutrition? What is your CRP? Your pre-albumin level? Have you been tested for possible osteomyelitis?

            (KLD)
            It's strange because I've never had this sort of thing before. A black spot appeared on the left side of my left foot around 5 months ago and got all red around it (half the size of a dime) so I spent all this time trying to heal that and around a month ago the same thing happened same foot only in a totally different spot (just below the big toe on the foot where the bone sticks out) and the exact same thing. Black spot which he said was dead skin and he cut it out and it is hopefully healing now.

            But ya, I'm really starting to wonder if this place is a cash cow, it is a wound care clinic with lines of people waiting to get in and I'm sure all being scraped every week like me. I had a 2:15 appointment weds and waited 2 hours to get in and no apology or anything. Why even bother having an appointment?

            He has me on cipro now because it looked like the skin around the wound was getting infected (red) and looks better now since I've been on cipro the past few days (skin is peeling a bit). I think at this point I'll just stay on the Cipro for the ten days he wanted me to stay on it, cancel my appointment for next week and try and let these things heal. He has me putting that cloth silver stuff over the wounds with a bandage. Was using the silver ointment but the wounds were getting to damp and forming a white skin around them.

            I'm getting really tired of all this. In fact I even feel wiped out. What does the test for Osteomylitus involve? I did have a bad infection same foot on the big toe for a couple months this past winter, toe was all red. I think it from a skin crack in between the toes.
            Last edited by Curt Leatherbee; 20 Jul 2012, 4:57 PM.
            "Life is about how you
            respond to not only the
            challenges you're dealt but
            the challenges you seek...If
            you have no goals, no
            mountains to climb, your
            soul dies".~Liz Fordred

            Comment


              #7
              tests for osteomyelitis, bone scan or mri.

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                #8
                I guess maybe I should have that done on my left foot, maybe it spread into my body because it seems lately my wrists ache a lot. There is no swelling of the foot and I've had no fever or anything. Thanks Craig.
                "Life is about how you
                respond to not only the
                challenges you're dealt but
                the challenges you seek...If
                you have no goals, no
                mountains to climb, your
                soul dies".~Liz Fordred

                Comment


                  #9
                  A non healing wound that continue to get infected despite antibiotics is why my doctors suspected osteo. If osteo is the diagnosis, important they get a culture and get you on the right IV antibiotic. No problem Curt, hope you get to the bottom of this, your wrist stop hurting, and you can go on bombing down the roads with your power pod.

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                    #10
                    stop using the silver stuff, get a debreedment topical medicine. ive healed 4 foot sores, i finally got a longer cushion and seat base and it took the pressure off my feet. also, you can get custom made pressure relief inserts you can put in your shoes. sounds like your shoes might be too tight also causing pressure. i never wore a shoe when I had them. i used this boot http://www.xtracareequipment.com.au/products/seating-pressure_care/pressure_relief/heelift_suspension_boot


                    i washed with saline n 4x4, or antibacterial soap, kept a 4x4 on it to catch the debreedment drainage. also, soaked foot in warm soapy water. and had attendant to rub it to get swelling down. stay on top of them or they'll get worse! good luck. oh, the doc debreeded but i dont think it was every week.

                    one sore on my 5th metatarsal was because I had toeless compression hose, they were too tight there argh!

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                      #11
                      I second the heel lift suspension boot and have been using them for at least three years now. I had a nasty heel ulcer which took forever to heal but haven't had one since using these boots.

                      Comment


                        #12
                        Curt, I struggled with a sore for pretty much all of last year and I did not have any improvement from weekly wound care clinic visits. If it's not improving, I'd seek a second or third opinion as to a course of treatment.
                        Daniel

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                          #13
                          I had a foot sore, and I changed dressing twice a day. Used hydrogel and covered it with gauze dampened with Vetericyn and covered it with microfiber (paper) tape. About once a week, after morning shower, I would debride the callus that built up around the edges. Took an 8mm sore about 3 months to heal.
                          Don - Grad Student Emeritus
                          T3 ASIA A 27 years post injury

                          Comment


                            #14
                            Thanks so much for the help everyone. This is definatly going to take some time to get rid of for sure. I'm changing the dressing on it twice per day and keeping a close eye on it. I'm very nervous I might have a bone infection or something more serious going on and am going to contact my general doc on monday to see where to go from here. I thought maybe I could be tested today so I went to the ER, big mistake, waited two hours and they told me it was going to be a lot longer. I'll contact my doc first thing monday AM. I tried calling him from my cell while waiting in the waiting room at the ER, but the woman who called me back after leaving a message with the answering service hung up on me because she said it was bad cell signal. The medical care industry is a whole different animal than private business, I wish I coulda hung up on people when I was in business so I would'nt have had to work, but you can't do that sort of thing in the real world.
                            "Life is about how you
                            respond to not only the
                            challenges you're dealt but
                            the challenges you seek...If
                            you have no goals, no
                            mountains to climb, your
                            soul dies".~Liz Fordred

                            Comment


                              #15
                              i left mine alone like we talked the black finally flaked away, perfectly healed now. took 2 mths, it was only size of erASER TO begin with
                              Bike-on.com rep
                              John@bike-on.com
                              c4/5 inc funtioning c6. 28 yrs post.
                              sponsored handcycle racer

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