#177360 - 01/16/10 10:55 PM
pressure ulcer debridment
|
Quickie
Member
Registered: 11/02/00
Posts: 55
Loc: Northern California
|
I know this is probably going to vary by many factors but can anyone tell me the usual frequency of debridment on a pressure ulcer. I have been VERY lucky in my 24 years post injury to have only had 3 pressure ulcers but my most recent (and current one) has been an absolute nightmare. It's location (on lower left butt cheek but to the leftside) and reason it ever developed in the first place was within 2 days when I had flu-like symptoms from a UTI (I started antibiotics for it later than I should have). The treatment I'm getting for it is at a new Wound Clinic in our rural area and they want to debrid it every weekly visit which I NEVER had done on any of my other ulcers. My other 2 were debrided one time on my first visit and with the 2nd ulcer a VAC closed it up from there. I've seen GREAT results from the last VAC and want desperately to use it this time but no one can figure out why the drainage keeps getting under the drape and falls off in less than 24 hours, which has also caused a really bad skin reaction (although that is not what they debrid). I questioned the new doc my last visit & asked why they keep removing any progress made and he got really pissed I questioned his "authority". He had one of those "God complex" personalities and I WON'T be seeing him again EVER!
Anyway, has anyone had an ulcer needing weekly debridment as a means to close it up?
Thanks, Gang!
|
|
Top
|
|
|
|
#177361 - 01/16/10 11:56 PM
Re: pressure ulcer debridment
[Re: Quickie]
|
flicka
Member
Registered: 04/06/00
Posts: 24616
Loc: SLO County, CA - 66.122.77.142
|
I questioned the new doc my last visit & asked why they keep removing any progress made and he got really pissed I questioned his "authority".
His anger probably stemmed from the fact that your wound HAD NO PROGRESS. He was removing more dead tissue.
Anyway, has anyone had an ulcer needing weekly debridment as a means to close it up?
When that happened to me, I ended up nearly dying and needing flap surgery to fix the mess.
You say you will never see this doctor again ever. What is your back-up plan? If the wound is not improving AND you are keeping pressure off the area, you need a doctor who can address the underlying cause of infection (probably in your bone). Good luck.
_________________________
"A lot of things were acceptable--until we stopped accepting it." -- Al Sharpton '12
|
|
Top
|
|
|
|
|
#177403 - 01/17/10 06:09 PM
Re: pressure ulcer debridment
[Re: flicka]
|
Paul I
Member
Registered: 02/24/00
Posts: 7913
|
Putting the dressing on for a wound vac is an art.
_________________________
"...only the shadow knows"
|
|
Top
|
|
|
|
|
#177411 - 01/17/10 09:32 PM
Re: pressure ulcer debridment
[Re: flicka]
|
Quickie
Member
Registered: 11/02/00
Posts: 55
Loc: Northern California
|
I questioned the new doc my last visit & asked why they keep removing any progress made and he got really pissed I questioned his "authority". His anger probably stemmed from the fact that your wound HAD NO PROGRESS. He was removing more dead tissue. There actually WAS progress that particular week but that (I'm not sure how much of the progress) was removed. The more dead tissue was most likely because the VAC issue of it not staying on was ignored instead of helping me find out why. Anyway, has anyone had an ulcer needing weekly debridment as a means to close it up? When that happened to me, I ended up nearly dying and needing flap surgery to fix the mess. You say you will never see this doctor again ever. What is your back-up plan? If the wound is not improving AND you are keeping pressure off the area, you need a doctor who can address the underlying cause of infection (probably in your bone). Good luck.
I had a flap with my last ulcer (+ osteomyelitis) and it's holding up GREAT. Unfortunately I have osteo again with this ulcer (not NEARLY as bad as last time) and it's MRSA which the hospital gave the last time. Surprisingly too not a single person at the wound clinic or hospital gown up like they should despite my expressed dissatisfaction with their lazy attitude about MRSA.
BTW, I forgot to mention the doc I disliked is not my PCP who see's me every other week there and I ADORE him!
Thanks!
|
|
Top
|
|
|
|
|
#177415 - 01/18/10 12:38 AM
Re: pressure ulcer debridment
[Re: Quickie]
|
Paul I
Member
Registered: 02/24/00
Posts: 7913
|
I don't see a problem with debriding every week unless he's doing too much. There are surface medications that will debride
also like Santyl (sp). You make it sound as if you would like to be back on the wound vac.
Osteomyelitis is tough. I've been on two of the most powerful antibiotics as an IV for about 10 weeks but a WBC scan shows it's still there.
How did they do the wound vac dressing. Did they put in a bridge?
_________________________
"...only the shadow knows"
|
|
Top
|
|
|
|
|
#177439 - 01/18/10 01:43 PM
Re: pressure ulcer debridment
[Re: Paul I]
|
paradocs
Member
Registered: 11/20/04
Posts: 2323
|
Putting the dressing on for a wound vac is an art.
Paul is right -- it is an art. My last hospital stay (2000-2001) resulted in a pressure sore on my tailbone. Since I was hospitalized, it was debrided and redressed for the wound vac MWF. The effectiveness of the dressing depended on who did it. Some nurses were not good at it and the seal didn't hold. Others had no problem keeping the seal.
|
|
Top
|
|
|
|
|
#177472 - 01/18/10 09:43 PM
Re: pressure ulcer debridment
[Re: Paul I]
|
Quickie
Member
Registered: 11/02/00
Posts: 55
Loc: Northern California
|
I don't see a problem with debriding every week unless he's doing too much. The problem is a lot of docs go against the human body's natural protectants and in effect "play God". A scab on certain wounds isn't always such a bad thing! There are surface medications that will debride
also like Santyl (sp). You make it sound as if you would like to be back on the wound vac.
I ABSOLUTELY would like to be on the wound vac (and it IS on again as of today because were trying the paste) because I saw first hand how fast and effectively it closed my last ulcer which was nearly 3X the size of the one I have now....IF it will STAY on and the drainage doesn't get under the drape.
Osteomyelitis is tough. I've been on two of the most powerful antibiotics as an IV for about 10 weeks but a WBC scan shows it's still there.
How did they do the wound vac dressing. Did they put in a bridge?
OH YES! We've tried every type and technique with the same disappointing result. If this paste doesn't hold it we'll have a KCI Rep come out as my last resort.
|
|
Top
|
|
|
|
|
#185251 - 04/03/10 05:15 PM
Re: pressure ulcer debridment
[Re: Quickie]
|
chipper
Member
Registered: 07/22/00
Posts: 212
Loc: Maryland
|
wow, sounds an awful lot like my experience! i have a doctor who wants to agressively debride my pressure ulcer every 2 weeks, which really angers me. his reasoning is that he wants to prevent the wound from entering a "chronic phase", and that by interrupting the tissues, he can avoid that. mind you, i've had the ulcer for only 4 weeks. it is healing well, but every debridemet sets me back by a week!
stay with your gut instinct. i told my doc not to debride anymore. i have a great home care nurse who has more than 20 years experience in wound care, and she says the docs want to debride so often because they can charge for a surgical procedure. it also increases your chances for getting an infection. obviously, there are times when debridements are necessary, but i don't think weekly sounds right to me. but i am not a doctor, nor can i give you anything other than my experiences.
i have the wound VAC and i had the same problem with drainage leaking from under the dressing. the wonderful nurse solved the problem by applying a layer of duoderm to the skin, then attaching the outer dressing to the duoderm, not directly to my skin. it worked out great and even though i was skeptical, i haven't had a leak since.
i know there's a controversy over whether the VAC system is really beneficial, but i've seen amazing progress since using it. well, also now i am home on bedrest in a clinitron bed.
i wish you the best of luck. it is a very frustrating situation, isnt it? i feel so bad for my husband, because he's pretty much the main caregiver and housekeeper for my 7 year old twins and 3 cats while i basically lie around all day. they are holding up better than i am!
|
|
Top
|
|
|
|
|
#187377 - 05/29/10 06:09 PM
Re: pressure ulcer debridment
[Re: Quickie]
|
mountaintrekker
Junior Member
Registered: 05/29/10
Posts: 1
|
I know your issue..I had a pressure wound on my left butt cheeck. It was no bigger than a quarter and had a little dead tissue. But the doctor would debrided it more than needed to be and made a mess. But he was a complete ass.. All he wanted was to do a wound flap and that's all he said he would do but I wouldn't let him so I went with the wound vac. Then I had to switched doctors so that someone would listen to me. I asked if there was anything else I could do to help it heal since the wound vac had stalled out the healing process. He let me try aquacel and lo and behold the wound liked it and started healing quickly. Grant it slowed down so all I had done was some stitches cause it was small enough for a few stitches which healed it up the rest of the way.. Another big help was switching my cushion from a roho to a ride design which has help big time...I hope this help..
|
|
Top
|
|
|
|
|
#187803 - 06/11/10 10:42 PM
Re: pressure ulcer debridment
[Re: mountaintrekker]
|
Susan34
Junior Member
Registered: 04/14/08
Posts: 24
|
There is a cure for pressure sores. One that I have found that has saved my ass (literally) on more then one occasion. It is an Amish cure, and believe it or not it is Preparation H, but you want to use the ointment not the cream. Because they have changed the ingredients in the cream, (use the one with fish oil in it)this is good for a pressure sore that is not already opened. You will be amazed at the results when you use the stuff!! I have no idea if it would heal an open pressure sore or not, because I have never tried it.
There is a cure that works really well for a pressure sore that is opened. You take one capsule of the herb, Golden Seal, open it and put it into a small bowl, then take a gel capsule of Vitamin E, poke it with a straight pin, squeeze it, and put it in with the Golden Seal, and mix the two together. Then cover the sore. Now you want to alternate this with Aloe Vera Gel, because Aloe heals from the inside out, and that's the way a pressure sore works it eats from the inside out. I have been in a wheelchair for 30 yrs. and have only had 2 pressure sores and have never had to have surgery because I have used these two cures. The 2 that I got were before I found the cures, and they were extremely small.
|
|
Top
|
|
|
|
|
#188239 - 06/24/10 08:53 PM
Re: pressure ulcer debridment
[Re: Quickie]
|
Little_Mark
Junior Member
Registered: 03/24/07
Posts: 14
|
Hi Quckie - I'm going thru the same issue now. I've been fighting this decub since Aug last year and my doctor wants to cut out down to butt bone and sew up or do a flap. I now have an infection and am on Cipro and Penecillin, which has set me back. I'm a T7 post injury 24 yrs and my first decub.
My doctor shaves around the edge of hole to make body think there is new cut and hopes the body sends cells to heal.
Still want to work my 6 hr day and have come to a point that I'm considering purchasing a cushion from Aquila called Airpulse which has a small compressor that fills and releases air under neath your butt so blood still gets to the area to heal the decub. Hoping to find someone on this site that has one and can let me know if this works or not.
Wish you a steady healing.
Mark
|
|
Top
|
|
|
|
|
#189032 - 07/13/10 09:25 AM
Re: pressure ulcer debridment
[Re: Quickie]
|
Millard
Junior Member
Registered: 01/20/05
Posts: 17
Loc: Plains, Georgia
|
After coming home after surgery for a broken femur, I hit my left ankle which turned into a pressure sore overnight. "Traveling Nurses" were ordered by my doctor. She came once a week and debrided the sore and applied fresh medicince. Three weeks later it had healed. Good luck.]
_________________________
Millard
--
"Life's tough. It's even tougher if you're stupid!"--John Wayne
|
|
Top
|
|
|
|
|
#190590 - 08/03/10 11:39 AM
Re: pressure ulcer debridment
[Re: Quickie]
|
haworth606
Junior Member
Registered: 05/13/09
Posts: 1
|
Yes, I have had debridement "put in a jacuzzi and sore bandaged" on a daily basis when I was in AZ. I think that treatment helped a lot. It was my first major ulcer. Plus, hanging in a jacuzzi with all the nurses was pretty cool and just my style.
I've heard the 3 best medicines are light, water, and fresh air. Other than that I find the Silvadene? creams to be effective. I have a constant sore on my tailbone. I'm prescribed lots of antibiotics but hardly ever take them unless my body knows its' needed...aka...i'm sick as a dog.
Jeff
|
|
Top
|
|
|
|
|
#193451 - 10/01/10 03:26 PM
Re: pressure ulcer debridment
[Re: Quickie]
|
lindac
Junior Member
Registered: 10/01/10
Posts: 9
|
our nurse used the plastic sheet that comes w/ it she trace the wound on the opposite side so that it was the exact size of the sore she cut the traced hole out and placed that 1st before putting the sponge in and then did everything else normally it will keep it dry and no extra leakage
|
|
Top
|
|
|
|
|
#193452 - 10/01/10 03:28 PM
Re: pressure ulcer debridment
[Re: flicka]
|
lindac
Junior Member
Registered: 10/01/10
Posts: 9
|
Our surgeon refused to do more than one he wanted a wet to dry bandage changed 2x a day within 2 weeks the nacrotic skin was gone and we were able to use the vac all healed
|
|
Top
|
|
|
|
|
|
