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Wound Vac Versus Flap Surgery




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#1 jscott92064

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Posted 29 March 2010 - 07:27 PM

Hi folks:

My husband is back in the hospital --for a UTI infection. But since he's there, they are recommending two choices for healing a pressure sore on his cocyx --wound vac, which they say takes longer or flap surgery, which means he goes under the knife.

Has anyone been faced with this choice? How did you choose? Why did you choose what you did? Is it possible to heal from a Stage 4 pressure wound with just a wound vac?

Thanks!

J

#2 *deb4604*

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Posted 30 March 2010 - 12:37 AM

Hi folks:

My husband is back in the hospital --for a UTI infection. But since he's there, they are recommending two choices for healing a pressure sore on his cocyx --wound vac, which they say takes longer or flap surgery, which means he goes under the knife.

Has anyone been faced with this choice? How did you choose? Why did you choose what you did? Is it possible to heal from a Stage 4 pressure wound with just a wound vac?

Thanks!

J


I've seen remarkable healing from wound vacs before and you should be able to see some progression fairly quickly. It may take time, but from what I've heard about flap surgery (no personal experience but there have been many postings in the past), I'd at least give the wound vac a try. It's a minor inconvenience at times, but I think well worth giving it a try.

#3 SuzinNYC

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Posted 30 March 2010 - 02:15 AM

According to my BF's doctors...who are great wound care specialists....Flap surgery is the LAST thing you try. Roger did really well healing soft tissue with the VAC, and had he been with this wound care team earlier, it may have been successful...but the bone partially died, and the flap surgery is necessary to remove the dead bone, since the infection won't go away unless the dead bone is removed. But this really is the last resort, a bit risky, and requires an extended (6 week) hospital/LTAC stay. Wound Vacs speed up the healing process by about 6 times the normal rate...and this is much less risky, requires bed rest, but a much shorter hospital stay. They usually combine the VAC therapy with infusion therapy if infection is present. You should be working with a wound care specialist that partners with an infectious disease doctor. VAC's really are effective, also a higher protein diet...everything to help healing. Good luck!

#4 mellowgator

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Posted 30 March 2010 - 03:47 AM

[quote name='jscott92064' date='Mar 29 2010, 07:27 PM' post='155398']
Hi folks:

My husband is back in the hospital --for a UTI infection. But since he's there, they are recommending two choices for healing a pressure sore on his cocyx --wound vac, which they say takes longer or flap surgery, which means he goes under the knife.

Has anyone been faced with this choice? How did you choose? Why did you choose what you did? Is it possible to heal from a Stage 4 pressure wound with just a wound vac?

Thanks!

J

scoobygimp has found a product called dermawound. below is his discription of how this product has healed his wound without the wound vac or surgery.

"I hate Mersa. As of this week I have given up on the vacuum treatment and the trips to the wound clinic. I found a paste that works better and faster than the KCI vac machines. The acti-vacs are a pain in the ass--pun intended. The dermawound stuff I'm using has produced more results in one week than the vacuum did in a month. A wasted month. It was wasted because I trusted the professionals who recommended it without doing my own research. I forgot my mantra "question authority" The vac actually macerated some healing skin and set me back. The technology is not cost-effective. The machine cost $26,000 and lord knows what the clinic is billing my insurance for the vac rental. I'm going cold-turkey on the vac and sticking with Dermawound. Google "Dermawound" by progessive doctors. The stuff is amazing and keeps MRSA at bay. It has given me confidence I will not need surgery. My Stage 4 wound is 1.5 cm by 2 cm and still has the dead white skin on the bottom of the wound bed. The vac did nothing to the dead white fiber crap (fibrin) but dermawound is dissolving it. Next month I hope to report a fibrin free and smaller sized wound. This is booorrring--hence my newbie game.. It is nice to have this community to turn to when you need a friend who can relate to your state."

if you have any questions let scoobygimp know he really has healed a stage 4 wound and it even handled mrsa.

mellgator
hi fellow gimps! i'm a c 6/7 quad and have been injured since 1986. i was in a roll over hydroplane accident and it took hours for the paramedics to get me out of the car in the pouring rain. that definately wasn't my day. but alas life goes on!

#5 Scooby Gimp

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Posted 01 April 2010 - 09:36 PM

The Dermawound is $40 a 16 oz jar. You have to buy it yourself but it is amazing and you can heal anything with around $100 outlay on Dermawound from Progressivedoctors.com. Medicare will pay thousands for the vac and the physicians obtain a higher reimbursement. But the vac does not have all the healing properties of dermawound. I had a 1 x 1 cm patch of fibrin slough on my stage 4 wound bed and it was still there after a month on the vac. Two weeks of dermawound dissolved the slough leaving a nice, clean, healthy wound bed. Google 'Dermawound." Quit wasting time and start healing.

Scooby vouching for Mellow vouching for me. We are..

Yours in the struggle,

Edited by Scooby Gimp, 01 April 2010 - 09:38 PM.

In trust of reason and the magic of nature,

#6 lynnea

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Posted 24 May 2010 - 08:16 PM

I was on the wound vac 2 wks after surgery. Doc took me off. no drainage. gave me alginate. Was allergic. I read DERMAWOUND has to be removed before walking around much..put back on at night. Is this so?? REGRANEX causes cancer warnings say. What to do? Dermablend? They said to walk to the bathroom is ok..walking the doc...cleaning / walking around no...it must be removed first. P;ease coment/email me. I lost my job and I soooo need to heal so I can sit. Yes it's in the fold of butocks. Scary place for infection risk. Thanks Folks and Blessings to you all. Hang in there. Lynnea


My husband is back in the hospital --for a UTI infection. But since he's there, they are recommending two choices for healing a pressure sore on his cocyx --wound vac, which they say takes longer or flap surgery, which means he goes under the knife.

Has anyone been faced with this choice? How did you choose? Why did you choose what you did? Is it possible to heal from a Stage 4 pressure wound with just a wound vac?

Thanks!

J

scoobygimp has found a product called dermawound. below is his discription of how this product has healed his wound without the wound vac or surgery.

"I hate Mersa. As of this week I have given up on the vacuum treatment and the trips to the wound clinic. I found a paste that works better and faster than the KCI vac machines. The acti-vacs are a pain in the ass--pun intended. The dermawound stuff I'm using has produced more results in one week than the vacuum did in a month. A wasted month. It was wasted because I trusted the professionals who recommended it without doing my own research. I forgot my mantra "question authority" The vac actually macerated some healing skin and set me back. The technology is not cost-effective. The machine cost $26,000 and lord knows what the clinic is billing my insurance for the vac rental. I'm going cold-turkey on the vac and sticking with Dermawound. Google "Dermawound" by progessive doctors. The stuff is amazing and keeps MRSA at bay. It has given me confidence I will not need surgery. My Stage 4 wound is 1.5 cm by 2 cm and still has the dead white skin on the bottom of the wound bed. The vac did nothing to the dead white fiber crap (fibrin) but dermawound is dissolving it. Next month I hope to report a fibrin free and smaller sized wound. This is booorrring--hence my newbie game.. It is nice to have this community to turn to when you need a friend who can relate to your state."

if you have any questions let scoobygimp know he really has healed a stage 4 wound and it even handled mrsa.

mellgator
[/quote]

#7 Wheelz 16

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Posted 09 August 2010 - 10:49 PM

Dermawound did not close my pressure sore. As soon as I applied the rocky mixture to my sore,it melted and dripped out of wound or onto my bandage. I have never met anyone that actually healed a sore using Dermawound.It does clean outt the wound ,but mine never got smaller. I closed mine with the wound vac.

#8 stillgotswag

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Posted 10 August 2010 - 12:09 PM

My vac has given me problems over the last yr. I've noticed it depends on how well the dressing is done, and you really gotta stay off your butt or it doesnt work properly leading to infection, tunneling, a host of problems. Flap surgery is a last resort.
I never did like snakes... so I got out the gutter.

#9 Tolob

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Posted 18 August 2010 - 04:13 PM

I have done both -- flap surgery 10 years ago, and wound vacs for stage four ulcers 8 years ago as well as presently (almost healed). The flap surgery seemed great -- six weeks of being immobilized was actually relatively short. However, the entire area broke down again two years later. The wound vac is slow and can be very frustrating, but it does work even for a very deep wound. The first time it took about five months, and currently I have been using it for three months. The battery lasts a long time and you can be somewhat mobile with it (although to really heal the wound you must be off of it). There are new materials which make it far less likely for the seal to leak. I think it is also really good at preventing infections.

Any pressure wound is a terrible thing, and the recovery process has been the most frustrating thing that I've ever had to deal with as a quadriplegic. But, my advice would be to go with the vac rather than the flap surgery.

#10 jscott92064

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Posted 18 August 2010 - 05:26 PM

I have done both -- flap surgery 10 years ago, and wound vacs for stage four ulcers 8 years ago as well as presently (almost healed). The flap surgery seemed great -- six weeks of being immobilized was actually relatively short. However, the entire area broke down again two years later. The wound vac is slow and can be very frustrating, but it does work even for a very deep wound. The first time it took about five months, and currently I have been using it for three months. The battery lasts a long time and you can be somewhat mobile with it (although to really heal the wound you must be off of it). There are new materials which make it far less likely for the seal to leak. I think it is also really good at preventing infections.

Any pressure wound is a terrible thing, and the recovery process has been the most frustrating thing that I've ever had to deal with as a quadriplegic. But, my advice would be to go with the vac rather than the flap surgery.



Just to update - we went with the wound vac and his wound healed up very nicely!!!! So glad we went that route! Thanks for all the advice.

#11 jffsgrl

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Posted 20 August 2010 - 07:03 PM

Hi folks:

My husband is back in the hospital --for a UTI infection. But since he's there, they are recommending two choices for healing a pressure sore on his cocyx --wound vac, which they say takes longer or flap surgery, which means he goes under the knife.

Has anyone been faced with this choice? How did you choose? Why did you choose what you did? Is it possible to heal from a Stage 4 pressure wound with just a wound vac?

Thanks!

J


My fiance has been fighting a pressure sore since the beginning of the year. He started off treating it with home health coming out two to three times a week and treating it, increasing his protein and taking supplements, a wound vac which only seemed to make it worse. More tunnels developed off the initial sore and due to the placement of his sore the vac would not stay on for more than 24 hrs. The vac seemed to be more of a hassle than anything, however, he wanted to try every option possible before contemplating surgery. After exhausting every option he consulted with his doctor and she referred him to a plastic surgeon who advised that a flap surgery is necessary. Here we sit today waiting for the call from the surgeons office as to when the surgery will be. Post surgery will consist of laying on his side in a "specialty" hospital for four weeks, however, this seems like nothing compared to the many months that we have been dealing with the sore. Of course, there is always a risk involved of the flap not working and other complications from surgery, but I think we are both ready to get this over with and move on my with our life!
LLH

#12 Scooby Gimp

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Posted 09 September 2010 - 08:59 PM

I healed a stage 4 pressure ulcer, which was over my left trochanter, with Dermawound and 12 hour dressing changes. You could see my hip bone in the wound at first, which was scary. But everything closed after 4 months with Dermawound, which i call "ass spackle." Cheers.
In trust of reason and the magic of nature,

#13 lrobertstoner

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Posted 05 October 2010 - 01:56 PM

Hi folks:

My husband is back in the hospital --for a UTI infection. But since he's there, they are recommending two choices for healing a pressure sore on his cocyx --wound vac, which they say takes longer or flap surgery, which means he goes under the knife.

Has anyone been faced with this choice? How did you choose? Why did you choose what you did? Is it possible to heal from a Stage 4 pressure wound with just a wound vac?

Thanks!


J

i have done three flaps since 2001 became sci in feb 1999 tried wound vac twice on last two surgery no help usually i will heal so much then regress deeper even with total bed rest and laying on belly surgery took care of prob and spent less heal time then the unfruitfull affects of wound vac

i have a problem since my last surgery i have been afflicted with a fiscula the doc wants to do surgery i am not to keen on that i am trying to find a natural way to heal this up any suggestions doc does not know if this is from old surgery or from the bowls said he has to open it up to find out help if ya know anything thanks robert

#14 wheelz316

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Posted 01 September 2013 - 01:30 AM

I've had the wound vac since March of this year. It hasn't healed completely, so I am going in for flap surgery on Tuesday. Ive had the wound vac in the past, for about 4 months, and it didn't do much, so I ended up having the flap surgery then too. Same spot 15 years apart.



#15 just2013

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Posted 04 October 2013 - 08:59 AM

My first Ischial ulcer was in late 2007 - 20 yrs post injury - which seemed to heel w wound vac therapy after 3-4 months (24/7 bed in rehab centre) and then back to situation normal.

 

until late 2012. Ulcer in same place. v large wound (100+ sq cm) under 50c size exterior wound - bone scan shows possible osteo myelitis is Isch Tuberosity

 

surgery to clean/debride wound which appears to be quite old (? long) but surgeons see no osteo so no A/Bs.

 

this time went on (8 wk) trial w portable wound vac therapy at home (community nurse 3*pw) and not 24/7 in bed. i am able to self care/cater/clean in my own home. In November & December '12 there is rapid healing and all seems well.

 

in january '13 i go interstate for 12hrs, and wound seems ok but over the next 3 months there is no real progress w 3-4cm deep wound (community nurse and plastics say wound has 'plateaued') and since April plastics want to do flap but ... i want that as v last option 

 

in July '13 wound vac therapy is ceased.

 

i had expected hoped to be back studying in indonesia by March '13 so i'm disappointed - instead i am doing part-time at home university.

the community nurse recommends promo-gran and wound seems to improve, albeit slowly.

 

i'm frustrated so i organise MRI and blood profile and, surprise, i have patchy osteomyelitis and blood CPR is 140 (norm is < 10) but no significant clinical symptoms.

i spike 39.4'C and have some night sweats (which have since stopped). 

 

I feel ok physically but i'm running out of patience cos my out of bed life is in 3 2 hr blocks per day. i have dark thoughts and it's spring outside.

 

shall i buy a stander? more time out of bed and less time sitting? anybody have an opinion/experience with the standmaster 2000?



#16 just2013

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Posted 05 October 2013 - 01:31 PM

ok so my post from last night was a bit long and i wound up highjacking the OP's thread. sorry for that.

I didn't realise i needed to write down what's been happening to me - probably should have thought it through before i started. oops, i'll resume lurking.



#17 luckycharms

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Posted 30 October 2013 - 02:21 AM

Just2013 just wanted to let you know I feel your pain. I have a stage 4 pressure ulcer on my left ishium that I've had since February 2012. It's varies from 7cm to 10cm in depth with extensive tunneling. And to make matters worse I've developed a strange opening on my left hip where I had foam coming out of that was left in the ishium wound. That one was 7cm at one point but has reduced to 3cm recently but seems worse by the amount of drainage coming out of it. I also have extensive osteomyelitis that encompasses my entire left ishium, acetabulum, and pelvic bones. I was on a wound vac from March 2012 till July 2013 with no improvement. I was put on a picc line with antibiotics for 3 months for the osteomyelitis which actually progressed instead of getting better. I am now taking a high dose of oral antibiotics for the last 3 months...which I haven't had confirmed if its helping or not. My doctors never even started talking flap surgery until June this year, after I found out I was pregnant. So surgery is out until at least February after the baby comes. I have had home nurses coming to treat me 3 times a week but there's never any change. They've been using medi honey as a last resort since nothing seems to touch these sores. But until the osteomyelitis is controlled there's no chance of healing. I've given up much hope of either of them going away at this point. Hopefully they can get the osteomyelitis under control and do whatever surgery is needed to finally get rid of these things.
Good luck to you. I wish you well.

#18 just2013

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Posted 16 November 2013 - 01:59 AM

thanks luckycharms for your wishes.

my mood has lifted since and, although the wound is still not healed it has progressed and i am optimistic - maybe it's the sunshine ;)

anyway, seems like you have an even bigger challenge than i - not only with the wound but also a pregnancy! wow and congratulations

good luck to you and yours!




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