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Forum Name: Surgery Topics

Question: Pressure wound, medications?


 BluePaul - Tue Nov 11, 2003 4:17 pm

My brother-in law was a victim of a motorcycle accident 3 years ago that left him paralyzed from the waist down. He's been able to use a wheel chair for a short time each day, but lately been bedridden for several weeks. My sister told me yesterday that he's developed a "bed sore" on his tail bone (Sacroiliac?) that has grown to approximately 4 inches in diameter. His "tail bone" is now exposed in the wound, according to my sister. He's been to the emergency room several times and had the wound "cleaned", but they just cover it and send him home. It continues to grow. Recently they brought in a machine that applies a small vacuum to the wound via a transparent plastic [quote]cover. [/quote]This "vacuum's" the plasma, and sloughed tissue on a continuous basis, by a portable battery operated unit that goes with him when on the wheelchair or in bed.
My question is [b]why don't they have him on an antibiotic[/b]? I asked pointedly, and they assert that no medication has been prescribed. I believe there is a strong possibility that the wound could become contaminated with Staph or worse, knowing that Staph is able to kill in 24 hours or less either by necrotizing fasciitis, or by menningitus via the spinal cord or through the blood system..
Please advise if my brother in-law is in danger, and if we should say something.
PS: Note that he has a doctor assigned, but has never actually seen him. He diagnoses by phone. This appears to be a circumstance of the insurance or rather the [quote]poor insurance [/quote] my bother-in-law has.
Please advise ASAP[/b]
 Dr. Tamer Fouad - Wed Nov 12, 2003 8:56 pm

User avatar Specific treatment of a bed sore is determined by your physician and based on the severity of the condition. Treatment may be more difficult once the skin is broken, and may include:

removing pressure on the affected area
protecting the wound with medicated gauze or other special dressings
keeping the wound clean
transplanting healthy skin to the wound area
medication (i.e., antibiotics to treat infections)

Antibiotics are prescribed in two cases. First, if the ulcer doesn't heal within a few days of non-antibiotic therapy. It should also be prescribed if there are obvious signs of infection.

In this particular case it is imperative that the patient be inspected by a physician. He may benefit from grafting surgery.

Regards,

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