4 replies to this topic

[Pithore]

Hi, just found this sight recently and it's great.

I recently had flap surgery done after a lengthy battle with my first serious pressure sore after 14 yrs of being in a chair. I was in hospital on bed rest for 3 weeks before they started my "sitting protocol." I had a strict routine when I was in the hospital starting with 10min/3xday when I first started sitting and slowly increasing every 3 days. I got discharged last week when I could sit for an hour, but the Dr. I saw wasn't sure how I could continue with my sitting time. She just told me to take it slow. I saw my surgeon today (1 week after discharge) and told him I had been increasing my sitting time by 30 minutes every 3 days and was at 2 hours now and he seemsaid that was fine and said everything looked good. But after he left another Dr. came in and when I told him I was sitting for 2 hours he told me that I should only sit for an hour up till 8 weeks (it's now been 6) and then increase by 15 minutes every 3 days.

I'm torn because of both conflicting opinions and the fact that after a yr and a half dealing with this wound, I really want to start living again. I always check my skin after I sit, and the only time I've noticed any redness is after I sit on my shower bench. I currently use a Roho cushion and am getting a Ride in a couple months.

The advice I was looking for:

1) Does anyone who has gone through this recall the specific sitting protocol they continued after leaving hospital?
2) Other then redness are there any other trouble signs I should be looking for?
3) If I am sitting for 2 hours and not seeing redness should I be confident that my skin can take that pressure regularly?

Edit: qbounce if you read this, I saw you gave some advice a few posts below mine. Just looking for a bit more detail, and how long should you leave in between sittings?

Thanks.

Edited by Pithore, 18 April 2011 - 11:19 PM.

[Raspberry]

I recently (Sept 09) underwent flap surgery to close a long-standing (2 years) ischial pressure sore.

The plastic surgeon had me lying flat post-surgery for 3 weeks, before starting the following 'sitting protocol' - 10 mins on day 1(in bed, on pressure-relieving mattress), 15 mins day 2, 20 mins day 3 etc...

After 1 week of this, I was allowed to be hoisted into a wheelchair, starting with 30 mins on day 1, then increasing 10 mins each day...

And then, after 2 weeks of this protocol, with checking by hospital nurses after each & every 'sit', the plastic surgeon was happy that my skin was sound enough for me to be discharged to home, with the recommendation that I pressure-relieve in my chair at 15 minute intervals.

7 months later, still no problems!

HTH

[Pithore]

Thanks for the reply.

It's good to hear you're having good results after the surgery.

I was off for about a year and a half laying in bed for 22-23 hours a day before getting my surgery, I definitely don't want to go through that again. As much as I want to go have some fun (watch out ladies) I'm fine with being really cautious right now. My OT from homecare came today and is going to look into a concrete guideline for me to follow as the doctors/surgeon seem more concerned with how the incision looks rather then how I manage it not that I'm home.

It sounds like your protocol is a bit more aggresive then what I followed in hospital and then the "loose guidelines" I was givien upon discharge.

I started at 3 weeks as well with 10 min x3 a day, but then it was increased by 15 minutes every third day. I wasn't allowed into my chair till I hit the 1 hour mark.

Did they give you a max in chair time when you were discharged, or did they just focus on offloading every 15 minutes and checking your skin?

Thanks a lot.

[Raspberry]

Pithore, on 20 April 2011 - 06:03 PM, said:

Thanks for the reply.

It's good to hear you're having good results after the surgery.

I was off for about a year and a half laying in bed for 22-23 hours a day before getting my surgery, I definitely don't want to go through that again. As much as I want to go have some fun (watch out ladies) I'm fine with being really cautious right now. My OT from homecare came today and is going to look into a concrete guideline for me to follow as the doctors/surgeon seem more concerned with how the incision looks rather then how I manage it not that I'm home.

It sounds like your protocol is a bit more aggresive then what I followed in hospital and then the "loose guidelines" I was givien upon discharge.

I started at 3 weeks as well with 10 min x3 a day, but then it was increased by 15 minutes every third day. I wasn't allowed into my chair till I hit the 1 hour mark.

Did they give you a max in chair time when you were discharged, or did they just focus on offloading every 15 minutes and checking your skin?

Thanks a lot.

No probs - my surgery was Sept 10 by the way, not 09 (doesnt time fly, I 'lost' a year hah)!

I'd been in bed for 2 1/2 years pre-surgery, while my local District Nurses (here in the UK) tried (wo)manfully to heal the sore up without surgery, so yeah, I shared your pain (or at least I would have done if I could feel any pain )...

Yeah - My plastic surgeon was quite happily confident in her own handiwork to discharge me into full-time wheelchair usage, provided as you say, I kept up the pressure relief, and plenty of skin checking! Have to say, everyone (GP, Spinal Consultant & District Nurses) who has looked at the wound area post-surgery says she (Plastic Surgeon) has done a fantastic job...I'll never forget her!

All the very best of luck to you - go hard on the protein & real easy with the ladies

[Pithore]

Thanks. And to tie in to the lost time theme, I decided awhile back that since I lost a year or so of my life I can actually tell people I'm really only 30 (I just turned 33).

And my surgeon was pretty happy with his work as well, he sounded like a conceited artist the first time he came to see me post surgery.

Cheers to us and our health