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    Sheering to a stage 2...

    Hi guys,

    During a trip home I managed to whip the scab off a spot on my bum and due to loosing weight my rather boney butt has developed quite a sheer, no doubt during transferring along a sliding board.

    It's quite a large size, approx 3cm x 2cm, and since the scab came it's been open. I know I should be on bedrest, but due to serious spasticity it is very hard for me remain in bed. I am still getting up on the sore and until today when we tried a duoderm patch I have sitting on it without a dressing (for the last 10 days). It's not got any worse, but no better either.

    Todays Hairy Ass Pic - and no, my nurse didn't clean my butt properly before taking the pic!

    It's very hard to find to adhere to such a hairy area, and duoderm tends to slip and stuff like versiva xc wont stick.

    Now I know I should be off it, I really do, but if any can suggest a very sticky dressing to use in such an area please let me know.


    Andy.
    C5/6 Tetraplegic, injured since 1990.

    #2
    Tegaderm may stick a little better. Also, some of the chain pharmacy stores carry their own brand. I am thinking that since they try to come in cheaper, they may stick better.
    CKF
    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.

    Comment


      #3
      Andy C.

      It would seem from your profile that you have the SCI miles to know better than getting up on a pressure area. Listen to your head.

      In my opinion 'not getting any better' can only mean it's getting worse in some way that is yet to manifest.

      As for 'sticky' stuff, maybe comfeel with tegaderm to secure the edges.

      Comment


        #4
        How does the wound look to you, CKF? I'm guessing your advice would be "GET OFF IT" also!

        I have tegaderm, but thought that may roll/wrinkle up when sliding on the board.

        Also, should I remove the dressing overnight to allow the wound to dry? It gets quite wet with duoderm and off course sitting (not smelly or colored).


        Andy.
        C5/6 Tetraplegic, injured since 1990.

        Comment


          #5
          Originally posted by brocko
          It would seem from your profile that you have the SCI miles to know better than getting up on a pressure area. Listen to your head.
          I know you're correct, but it's the first time i've ever had a skin problem in 17 years, so never needed bed rest.... and the thought of it when i live alone scares me...


          A.
          C5/6 Tetraplegic, injured since 1990.

          Comment


            #6
            Originally posted by Andy C
            I know you're correct, but it's the first time i've ever had a skin problem in 17 years, so never needed bed rest.... and the thought of it when i live alone scares me...


            A.
            I really think skin issues are worth changing your lifestyle/routine for. As about a million people here can tell you, the longer you leave it the longer it takes.

            I imagine the thought of being trapped in bed, and all the functional limitations that ensue, is what presents the barrier for you.

            If it was me (and time to sound like my mother here!) I would be taking whatever steps necessary to see improvement. Have you thought about hiring a pressure relieving airflow mattress? This may be a good compromise as it allows you to lie on your back in bed whilst still offering a therapeutic benefit, from this position you should be able to arrange access to telephone, remote and lap top/computer.

            Make sure you keep your fluids up, vitamin B if possible, and think happy thoughts

            17 years without major issues is a bloody good run, take your medicine now. Don't take this the wrong way but I think without experiencing how difficult these bloody things can be you may not be appropriately frightened.

            just my two cents/pence.

            Comment


              #7
              I am making plans for the event... i've found a company I can hire a profiling bed from which I can put in the front room where the tv, stereo, etc. is, plus it's on wheels so I can spin the bed round when turning. Also looking for a laptop, i'm wifi ready thankfully!

              So hopefully off my butt in a cpl of days time.
              Last edited by Andy C; 15 Jan 2008, 9:07 AM.
              C5/6 Tetraplegic, injured since 1990.

              Comment


                #8
                Cool.

                Pity you have to buy a laptop for the occasion though

                Comment


                  #9
                  Oh Andy ..... take care of that shear .. it looks just like what Bill's looked like "in the beginning" and here we are over a year later still dealing with it. If you can keep it clean and moist for healing ..... ZERO ZERO pressure .... you've got a good chance of nipping this in the bud!!
                  I know it looks like nothing to get too excited about but don't be fooled .. get off it .... now ..... please ! It's unbrelievable how quickly these damn things can get ugly ..... all the best and take care!

                  Obieone
                  ~ Be the change you wish to see in the world ~ Mahatma Gandi


                  " calling all Angels ...... calling all Angels ....walk me through this one .. don't leave me alone .... calling all Angels .... calling all Angels .... we're tryin' and we're hopin' cause we're not sure how ....... this .... goes ..."
                  Jane Siberry

                  Comment


                    #10
                    i'm no doctor lol. i have had a couple sores on my ankles and the nurse who came to the house to take care of them always used duoderm. the sore took 4 months to seal up and heal. i think the duoderm just keep the area wet all the time and it could never seal up and heal. i got one about 2 weeks ago from the bracket that holds the foot plate assy to the chair. theres a real sharp edge there. had a spasm and it ripped the skin right off. i just cleaned it 3 or 4 times a day with that dial foam anti stuff. it sealed up in about a week. now i have a scab. i wear thick hunting socks during the day to protect my feet. at night , i take the socks off. i sleep so the scab never touches anything and can breathe. bottom line , get it to a scab and stay off it. that duoderm is crap.
                    oh well

                    Comment


                      #11
                      Originally posted by kenf
                      i sleep so the scab never touches anything and can breathe. bottom line , get it to a scab and stay off it. that duoderm is crap.
                      A lot of what you say is true kenf if you can get it to scab over that's good ... I've used sterile saline to clean Bill's ankle sores and then just cover it with a 2x2 and a piece of Mefix with some success.

                      I think butt sores are trickier though .... I've never been able to figure out how you would get a sore there to scab over .. maybe someone else has an idea. I guess if you could lay on your belly all the time, keep it clean and cover it with gauze it might work ... Bill has an ileostomy so that won't work for him!! We have used duoderms in the past and they've worked pretty well .... but then we've used just about every dressing covering known to man I swear so its possible I'm getting them all confused in my mind!! And I can't say it enough ... the low air loss bed played a significant role in healing Bill's wounds ....

                      Obieone
                      ~ Be the change you wish to see in the world ~ Mahatma Gandi


                      " calling all Angels ...... calling all Angels ....walk me through this one .. don't leave me alone .... calling all Angels .... calling all Angels .... we're tryin' and we're hopin' cause we're not sure how ....... this .... goes ..."
                      Jane Siberry

                      Comment


                        #12
                        We've not had much luck with Duoderm either, for the reasons others have stated; yes, it's important to keep the wound bed moist, but not 'goopy', which the Duoderm seems to do.

                        If you're going to put any kind of occlusive dressing (adhesive) on it, I'd recommend shaving the area first and using a skin prep.

                        We've been using a collagen gel on a small wound my son has at a drain site from his graft surgery. It's working very well, seeing improvement every day, and we just cover it with a smooth gauze and paper tape.

                        Having said that - if you've never had a wound before, I'd go to see a wound care doc/nurse and let them evaluate it first, instead of trying to self-treat it. Wounds are so different from each other, and there are so many products out on the market, it really helps to get some guidance as to what direction to move in.

                        I do agree with everyone who says 'stay off it!'. It's a litany here, but it's true. You can either treat it now with a relatively short time in bed, or deal with it later with a much, longer, more intense time in bed. Your choice!

                        edited to say - Please don't think I or anyone else is insensitive to your feelings about being bed bound and 'home alone'. Do you have friends/family who can check in on you and at least get you set up with food, etc?
                        _____________

                        Comment


                          #13
                          My biggest issue with bedrest are the other problems I am having, reported here. Seems like everything is going wrong.
                          C5/6 Tetraplegic, injured since 1990.

                          Comment


                            #14
                            Andy:
                            You know that you need to get off of your butt. I agree that you should be seen in a wound care program- even though it doesn't look like much right now. They may have other ideas that may work better. Shaving around the area will help. I tend to stay away from skin barriers but that is a personal preference. I have seen them make a mess of skin- primarily due to the stickiness.

                            I have had problems with tegaderm, but also seen good things with it. You don't want to dry out the wound bed- you need to keep it moist to get it to heal.

                            Also, make sure that you are drinking plenty of fluids, eating high protein diet and a balanced diet.

                            When you get off of the area, make sure that you turn and position yourself frequently. (Sorry, that is the Mom in me....) And stay off of it as much as you can. Any transfer or sitting just jepordizes the area.

                            CKF
                            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.

                            Comment


                              #15
                              Originally posted by Andy C
                              My biggest issue with bedrest are the other problems I am having, reported here. Seems like everything is going wrong.
                              EEks - Are you having problems turning yourself because of your other issues? Don't know your insurance situation, but is there a possibility your doc could order some home health care for you?

                              I know the feeling - sometimes it just seems like it all piles on at once.
                              _____________

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