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Finally, because the surface necrotic tissue was not breaking down, the clinic doctor got a bit more aggressive cutting the stuff away. Up until that point the wound was unstageable, because we could not see what was happening below the surface. It was alarming to see the wound was about the size of a golf ball, with little end in sight of healthy tissue in the wound bed. He was sent immediately to the hospital for surgical debridement. That was Feb 14 (Happy Valentine’s Day!) and he is still there.
Since then it has been an unending barrage of complications; antibiotics for multiple infections, colostomy, horrible pain, weakness and loss of lucidity for a period. They have had him on a wound vac for several weeks now, with not much success, I think. Whenever I see the wound, it still has a lot of necrotic tissue, appears to be bigger, and has undermining all around the circumference of the wound. He has had several debridements and is scheduled for another this week.
The doctor is now talking about the possibility of a wound flap. I have had one surgeon tell me he would not be a good candidate for the procedure because of his medical history. The Reader's Digest version includes a history of 2 aneurysm surgeries (both involving massive complications from heart attacks on the table during surgery to removal of a rib, spleen, and part of his colon in addition to placement of a heart valve and partial aorta replacement), gastric complications following the recent colostomy surgery (which has since settled down-but this is a constant following any invasive surgical procedure now), unstable blood pressure that sometimes swings wildly between dangerously high and dangerously low, he has been in nearly constant pain since becoming paraplegic, has had anklyosing spondylitis since he was a teen (leaving him with a partially fused spine at the neck), recurring UTI and infections in the wound, and another small aneurysm detected in his brain behind his right eye. Believe it or not that is the short list.
We have a great deal of confidence in the doctors. They just keep patching him up. But this is just an unbearable situation and although I am pretty astute about assessing options at any point along the way, I am no longer certain what we need to be asking or what other concerns we should even be exploring. Thanks for plowing through all this and any suggestions you might have.
Edited by Carolinedm, 17 April 2011 - 01:46 PM.
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