[hillarymcarter]

I am an expert on bed sores! My hubby and I have been through the ringer when it comes to those!
First of all, you need to make sure the wound has been debreeded. This means there should be no dead tissue left in the wound. Dead tissue will be black or yellow in color. If it is not debreeded, someone at the home health agency may be qualified to debreed it or he may need to go to a dermatologist. Very important-A wound vac WILL NOT work if there is dead tissue in the wound. The vac should be set at the maximum setting (usually 150) and maximum intensity (usually 10).
Secondly, He should not be on the sore at all at any point in the day. He needs to be on bedrest and he should alternate sides and if possible lay on his stomach some.
He should definatly see a doctor. If you tell your nurse you want to see a Dr. they must recommend one by law. I can't believe they didn't send him to a doctor when the sore first developed.
I would also highly recommend that the caregiver learn how to operate a wound vac. If I hadn't learned how to work my hubby's vac his nurses would have torn his bottom up by now! Just because someone is a nurse doesn't mean they always know what they are doing. Actually, very few nurses have actually been trained to work with a vac. You need to insist that a wound care nurse come with the regular nurses for every visit.
Good luck, sores can be a pain! If the vac doesn't clear this up then you need to look into getting a flap surgery done. They will pull his remaining muscle over to fill in the hole left by the sore.
How deep is the sore? Make sure it gets measured every time they change the vac. (On a side note, make sure the vac gets changed at least every 3 days.)

[carolline]

Hi Dixie,

Hillary is right,she gave you the details about the sore and the VAC.
I just want to add,make sure that the Vac do'nt have any leak.Coz sometimes it seems the vac is on but there's a leak from the dressing itself.Anyway the machine will beep and it will tell what's wrong on it.How about the theraphy setting is it continues?Coz the VAC there is a Theraphy Settings ussually here we used continues theraphy.Make sure your mother knows how to operate it.Coz if there will be changes happened about the VAC settings it will not work to the wound or the healling will be slow.Is the home care nurse vissiting him everyday?She need to asses and document every changes of the wound,about the size,depht,color, appearance everthing,when she will change the sponge vac.So that they will know if its improving or getting worst,and she need to refer it to the doctor.

You need to send him to the doctor.Sometimes the assesment of nurse is different to the doctor.

Good luck.

[john S.]

Dixie, on Aug 21 2005, 06:57 PM, said:

[SIZE=7]I am worried . My brother has been a quad for 31 years and is now in bed with his first pressure wound. he is being seen by a home health nurse and has not been seen by a physician. His wound is a stage 4 and he is on a wound vac and been on bedrest for 3 months, the wound keeps getting larger. They live in a small town and the nurse says the dr. won't see him. I am afraid for him and my elderly mother caring for him. What can I do. Where can I go for help? Any suggestions will be greatly appreciated. I am worried sick.
Thanks for any guidance,
respectully ,
dixie

they live in northern va.

Dixie, a stage four wound needs a doctor to see it. Check to see if theres a "wound Care Center" anywhere near you. Start keeping track of your brothers vitals. That type wound can cause autonomic dysreflexia. If it is expanding it is probably dead tissue falling away. This tells me that his nurse is not qualified to do anymore than grade a wound and is not qualified to recommend any treatment. The wound vac is useless if the wound isnt debrieded properly.
Never let him lay on that wound (although I'm not sure where it is at). All wounds are different due to position, size, depth, and the patient.
Take photos and send them to the doctor. Hound him/her.
Anyone less than a doctor is just playing about with a stage 4 wound.

john

[Apparelyzed]

john S., on Sep 23 2007, 09:13 PM, said:

Dixie, a stage four wound needs a doctor to see it. Check to see if theres a "wound Care Center" anywhere near you. Start keeping track of your brothers vitals. That type wound can cause autonomic dysreflexia. If it is expanding it is probably dead tissue falling away. This tells me that his nurse is not qualified to do anymore than grade a wound and is not qualified to recommend any treatment. The wound vac is useless if the wound isnt debrieded properly.
Never let him lay on that wound (although I'm not sure where it is at). All wounds are different due to position, size, depth, and the patient.
Take photos and send them to the doctor. Hound him/her.
Anyone less than a doctor is just playing about with a stage 4 wound.

john

John,

Not sure if you noticed, but the post you replied to is over 2 years old!

Simon.