Suck On That. Suck It Long, Suck It Har...at 80 mmHg
Time for something different. When I learned in March that I would need a third debridement and ischium biopsy peformed on my pressure sore, with the prospect of losing an entire summer on the couch, I wanted to know if there was a better way to end this predicament. Much to my frustration, my doctors at UM Plastic Surgery were more than satisfied with the way they felt my wound care had progressed. Yes there have been setbacks, but the problem up to this point has been a lingering myelitis bone infection deep in the wound that prevents the regrowth of tissue over the biopsied area of the ischium. If the wound doesn't heal from the inside out, it will never heal properly. In the view of my doctors at UM, they have pared down the area of infected bone and with this third ischiectomy and another course of IV antibiotics, they are confident this sore will finally heal as is it supposed to. When questioned whether or not there was anything I could do in addition to what we've already done, the answer was, “No, not really.” While they might be right in assuming that if they finally kill off the infection the wound will heal from the inside out and no further debridements will be necessary, they've also be wrong twice so far and I've lost eight months to this sore. I decided to look for other options. I'm now entrusting my wound care to the Wound Healing and Hyperbaric Center in Westland, MI, an extension of Garden City Hospital. My main reason for selecting the Wound Healing and Hyperbaric Center was the availability of hyperbaric oxygen treatment which is supposed to provide excellent support in healing all sorts of chronic wounds (more on that later). This is a therapy not offered by UM. An additional reason influencing the decision to work with the wound specialists in Westland is their willingness to try other wound treatment options. At UM, the extent of the suggested wound care regimen was twice-daily wet-to-dry dressing changes and after a course of antibiotic treatments application of the growth factor medication Regranex. Again, other treatment options were not suggested or recommended. At Westland, during my initial consultation, several treatment options that had been suggested to me by visiting home health nurses I've spoken to, but not favored by the doctors at UM Plastic Surgery, were discussed from the outset. One of those treatments is negative pressure therapy, also know as a wound vac. Negative pressure therapy uses suction to enhance the capacity of the wound to heal. The suction increases blood flow to the wound bed similar to the telltale signs of a junior high, hickey-inducing makeout session. The increased circulation brings much needed oxygen to the tissue critical to wound repair. In addition, the suction removes harmful waste drainage away from the wound site. With the waste drainage removed and increased blood flow to the wound bed the formation of granulation tissue is enhanced. The granulation tissue is the base layer on which skin cells can form. After increasing circulation and removing the excess fluid, there is also a diminished opportunity for harmful bacteria to take root in the wound. All of these characteristics of negative pressure therapy are encouraging when compared to the alternative of what I've been doing. Some of the research suggests that negative pressure therapy doesn't necessarily speed up the healing process, and I will have to carry around a small vacuum unit with conspicuous tubing running from my wound and out of the waistband of my pants. Even if the speed of the healing with he wound vac is negligible compared to more traditional methods, at this point it is worth a try.
