Small Wounds, Big Problems

By George F. July 26, 2011

Small Wounds, Big Problems

By: George F.

I want to share an experience and information about a wound. Approximately two years, I received a fistula (skin tear), on my right inner thigh and buttocks area from a Hoyer sling. The fistula was treated by the wound care nurse at the VA, and also by a civilian doctor off and on. But it was only being treated when it would bleed. All the treatment did was treat the surface area and get it to close. My wife, who is my caregiver, even pointed out that there appeared to be a knot with the fistula.

Last December 8th, I went to the doctor’s and he found an abscess under the fistula. By the time that he finished removing the abscess, it left a wound 3½ cm wide by 6½ cm long and 4 cm deep. We started to treat this with the standard method of wet to dry dressings. This went on until March 7, 2011. On March 7, he referred me to the Sparks Wound Care Clinic.

On March 10th, I had a bone scan done and began IV antibiotic of rocphin. After two weeks, the doctor also started me on another IV antibiotic of primaxin. I received one dose of rocphin and three doses of primaxin daily until the 19th of April. At this time, I began having side effects with the primaxin. So, I remained on the rocphin, with an increased dosage. I was also on a clinatron bed (sand-air). I remained on the rocphin until June 26th. The doctor also put a wound vac on April 7th.

On June 28th, I went on two oral antibiotics, one for a bladder infection, and one for a staff infection. I had an allergic reaction to the staff infection medication. So, the doctor started me on another oral medication. Upon completion of taking these antibiotics, the bladder infection cleared up, however, not the staff. So, I am now back on the IV’s of rocphin daily. The good news is the wound is now 1 cm wide by 1 cm long by .5 cm deep. Still have the wound vac on.

It has been a very learning experience, all from a sling tear, that is necessary to move us. The reason that the sling tore the skin was caused by two things. First the sling was not being checked to ensure that it was not pulling or putting pressure on the thighs; second, as long as we are paralyzed, our skin loses its elasticity due to the atrophy of our muscle tone.

Hope that this is useful information for both people with paralysis and caregivers alike. I know that we have learned a lot from this episode.