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Very Slow Healing Pressure Wounds

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  • Very Slow Healing Pressure Wounds

    Ive been a T-6 para for about 15 years and havent had issues with pressure wounds until recently.

    Currently I have four pressure wounds. Two on my back side and one on each hip. They range in size from about 3.5 x 3.5 inches in length and width and about 0.5 inches in depth. I have had them for about 10 months which includes 2 months in hospital and 2 surgeries to debride them. Been out of the hospital for about 8 months and the wound sizes have barely changed. Ive been to a wound doctor and they are clean with decent granulation. I sleep on a low air flow air mattress and limit my time in my wheelchair to about one hour a few times a day. My diet is good and Ive been on about 100 grams of whey protein daily. Any suggestions on how I could speed up the wound healing would be greatly appreciated.

    Also the wounds have considerable drainage and one month's worth of bandages (Stratasorb), tape and an absorption item (Enluxtra) costs about $2000 through my Health Insurance so this is also something I could use suggestions on to reduce costs.
    Last edited by JMD; 03-02-2017, 10:22 AM.

  • #2
    That is awful! I have one bad one right now that is turned into osteomyelitis. Surgery next week. I have been battling them for years now. I have no answers only sympathy. I feel like I'm doing everything right also, and lousy results.
    www.symbolofstrength.com

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    • #3
      Hope your surgery goes well. I had osteomyelitis too.

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      • #4
        When I went to the wound clinic in Minneapolis they first used mesalt covered with a duoderm bandaid for about 10 days. Putting salt on a wound speeds healing and cleans the wound. Then I did promogram covered again with the duoderm. Mesalt and promogram and duoderm can actually be bought on Amazon. Both pads can be cut to just cover the would then the duoderm bandaid. You will soon feel the center of the bandaid turns to jelly like. You leave them on for 2days at a time. This all costs about 40.00 for a week, sometimes less depending on the wound size. Now when I first had one it was close to 800.00 at the clinic pharmacy. I have only had one other small wound. Mine were scrapes on my lower hip while transferring . My first one was pretty gross since it happened just after I got out of the hospital and did not know anything about the slow healing process or how to care for a wound.
        The items last quite awhile since you cut them to fit.

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        • #5
          A lot of drainage is indicative of osteomyelitis. Also non-healing? Osteomyelitis. Go back to the doc and ask for an MRI or bone scan.
          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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          • #6
            Yes, I am also using Mesalt on the wounds. I also previously used Puracol which I believe is similar to Promogran.

            As for the Osteomyelitis, that was a previous pressure wound back in 2014 (surgery and some bone removed). These wounds developed in 2016 when my stair lift broke and I was sleeping on a recliner instead of the air mattress.

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            • #7
              Osteo never really goes away. Most often, it stays in your body in remission. Trust me on this; I'm the pressure sore queen. Have lost two pieces of bone.
              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
                i am with lynnifer you really need to get an MRI especially since you have had it before. like she said osteo NEVER goes away. i thankfully have never had it but when my wounds weren't healing they thought it was osteo but the MRI said no. 3 surgeries later it is now healed.
                T6 Incomplete due to a Spinal cord infarction July 2009

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                • #9
                  JMD,

                  Sorry to hear about your current situation. I'm a C7 23 years post injury. From the sounds of it you have other issues going on in the sore. Probably osteomyelitis. It sounds like your sores are at least stage 3, probably stage 4. The mattress you are on is not going to be sufficient to heal your wounds. You should be asking about air fluidized beds (Clinitron). You should also be off of the sores 24/7 but based on where you say you have them, that's going to be virtually impossible on the mattress you're using. You should talk to your wound care doctor and be giving serious consideration to muscle flap surgery. You could spend years trying, to no avail, to heal these up on your own.

                  I've had recurring issues with sores and have had three flap surgeries over the past ten years. While the procedure and subsequent recovery and rehabilitation is long and generally not pleasant, it works and, as far as I'm concerned, the only reasonable way to remedy your problem. You're looking at 6-8 weeks of laying in a Clinitron 24/7, no exceptions, and then 2-3 weeks of rehabilitation to start getting back into your chair and regaining your strength. After that you still need to be very diligent about minimizing the stress on the surgical site for a while because, while it is closed, it still hasn't regained all of its strength. That will take about 2 years.

                  I see that you are located in Pennsylvania. I'm located in Pittsburgh. If you are interested in considering air fluidized therapy you might want to call Star Medical (610-554-3367) and talk to them about getting a bed. They're outside of Philadelphia. They will work with your insurance to get it approved and get you what you need one way or another. I had a lot of trouble getting the air fluidized bed for treatment and recovery from my surgeries and once I found them they made sure I got what I needed. If the insurance is having issues with approving this equipment, let me know. I started a non proift charitable organization that helps patients in this type of situation get the equipment they need but don't have access to because of certain barriers. Let me know if this woks out for you or if you need any assistance. Good luck.

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                  • #10
                    Hmmm, lots to think about. Im so tired of going through this and the thought of possibly a longer time is very disheartening to say the least. I have literally had no life since this all began almost 3 years ago. I guess its back to the doctor. Thanks for all the replies.

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                    • #11
                      I am *hoping* that the current concentration into epidural stimulation will lead to less pressure sores. Not sure if you're flaccidly paralyzed like myself, or do get spasms .. but it might be something to invest in, or at least think about, after you're finished with your current wound healing.

                      Trials do show that e-stim does promote healing.
                      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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                      • #12
                        MRI and then bone bx. by Interventional Radiology. 6 to 8 weeks of IV antibiotics.
                        We are using Biobag from Biomonde for debridement also now.
                        CWO
                        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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                        • #13
                          I have always thought it would have been a great idea to be proactive. ie, alternating pressure mattress, standing or tilt and recline wheelchair and some type of estim to prevent atrophy from day one. I don't know why they don't just pay for this stuff at the very beginning and save us all a bunch of pain, aggravation and ultimately money in the long run.
                          ^^(A)^^

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                          • #14
                            Try some medihoney gel or paste. Worked wonders on my sores it can't hurt?

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                            • #15
                              I agree that medihoney is great .. for superficial wounds. Not for something that might have osteo though.

                              Agreed darty ... too bad they didn't issue us all e-stim products or have something like that ready to avoid a lot of troubles later on.
                              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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