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Pressure wounds

Matt32
1 Recommendation

I've had what started as a pressure sore no bigger than the size of your pinky finger, that is until the surgeon I went to debrided it and all and made it look like a cave(ok exaggerating here) but seriously, the doctor debrided it and everything and made it huge. Long story short, it's been going now 16 months with alot of improvement thanks to my family physician referring me to another doctor, who seems to care more for his patients than the almighty dollar(no offense to any doctor or nurse who come here). Up until November 2008, I was on the wound vac(Freedom vac version), until he suggested Medihoney, which works great. Now, he has suggested I go back to the vac for a part of the wound that isn't healing as it should. The company sent me their new vac called the Activac and after familiarizing myself with it, my question is as far as an intensity level, what should be the setting for the part of the wound that looks like it's tunneled? (Note: I can't see the wound but it being described, they say it is tunnel like). Thanks to anyone for the input.

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Surgery Pain Burns Acupuncture Paraplegia

40 replies

Learning1

Tears from Heaven's comments are one of the reminders that some of the old remedies are often the best. She mentioned pure vasoline as being a key for her.

The old tried and true method, from before antibiotics, is the one related in the naturopathic magazline link mentioned before (http://www.naturalnews.com/z026812_sugar_antibiotic_honey.html). In that they use a ring of gauze, saturated with a pure vasoline, and twisted like a rope, around the edges of the sore. Then they packed the sore with 1/4 inch of sugar, put a sponge on top of that, and bandage that. Or you can use honey instead of the sugar. And change the bandage every day. My sister has heard of several cases where this worked well, and the article relates a number.

It has apparently prevented surgery, and brought helped the body heal itself completely, avoiding the need for surgery, in a large number of cases over the years. So before surgery of any type is considered, it sounds like this would be worth trying.

Of course, with this, try to stay off of the area as much as possible. The area needs its energy to heal, and the one way it has to supply the energy itself is by the blood flow.

Also, those into energy medicine point out that sick or ailing cells have lost energy. Basically, they lose electrons, or the electrons if present drop to a lower energy orbit. What they have found where they do tests and trials, and when people do experiment, is that healing is speeded up when appropriate energy is added. This seems to be part of why things like lasers, speical lamps like the bitron, pulsed magnetic, electric stimulation (i.e. the electronic bandages), and even scenar help. Even thousands of years ago, doctors would proscribe sunlight, and this seems to be part of the same mechanism. If you have access to one of these modalities, it would also be worth trying, and regular use is what seems to help the most.

tears_from_heaven

Hello everyone,

I came across these site looking for information on pressure wounds or ulcer wounds, in 95 I got my two wounds from sitting a lot I had a tumor as a young child which left me legs weak with some feeling, and movement, but not enough to walk.

On my buttocks area my feeling is 100% but I do have some feeling after being in the hospital with a blood effection in 95 I had never been admitted since, my wounds aren't very big thank god but have opend once 01, 06 which both times I took care of them at home now in 09 the one on the left side turned into a blister I was told that's the way of the body to heal the one right was a small opening.

So I went to a wound clinic I was given a epadrema cream I think I spelled that wrong sorry and was told I should cover that came very handy I was told I might need a skin graft. The wound on the right looks more like a burn rather then a wound, on my next visit so was happy to see it was healed and was told to continue putting on the cream just alone.

Well the wound on the left became like a blister again meaning having undercovered didn't work, so talking to a friend she told about some bandages with anticbatics you can find them at any drug stores those worked like a miracle but I wanted another clinic to see me.

So I went again to another wound clinic seen buy a doctor see the first wound clinic I went to I was never seen by a doctor but a nurse in charge who pass it on to the doctor. Well the second was clinic I was told my wounds were clean and closed but with time the one on the left would reopen because its on my bone and the fact that I have lost weight since I was watching how much I weigh.

I was 140 5 yrs ago ...then 2 years ago 128, and now 112 having a lot of weighted doesn't help the wound because that means more pressure when sitting on them. She said for my wound on the left I should get the flap operation which tissue and mucles are moved to the location of the wound to fill in the wound, but if not careful I would have to more wounds.

She gave me a name to a plastic surgeon who she said works wonder on ulcer wound but he would not take me because he won't take medicaid. I went on the internet searching for a plastic surgeon who took medicaid and no luck at all, so I went to my third wound clinci this past Monday.

Only to be told to stay away from any type of surgery because it was a 100% that it would work, and I would be dealing with another wound to heal he said I have done a great job keeping them healed he suggested not sitting on my buttocks so much but that's not that easy.

I don't know what to think one tells me I need a skin graft another tells me I need a flap operation, and the third tells me I should leave that as my last resort.

Here's what I have used at home remember my wounds are very big so if your wounds aren't big these might work as it did me.

1. Epadrema cream which I am sure I got the spelling on that wrong sorry.

2. The bandages with the aintibotic I got mine at walgreens I believe their from johnson and johnson.
Believe that worked wonder their only 8 in a box for about $ 10.00 if not mistaken.

3. My NUMBER 1 top secret pure vaseline my god I can't say how this worked for better than anything just put a lot on it, it helps against cuts, and burns. If anything has come to me in a blessing is this I put on night time a lot of it and a smaller amount in the morning or evening.

Other things I was told to use : pure olive oil the doctor at the second wound clinic suggest this can't say it worked cuz I haven't tried it.

And on my thrid vist coco butter it helps smooth out the wound will be trying this sometime this weekend, I am still using the vaseline .

I read amanda's story and I cried when I found out she passed away to bad she didn't stay off her wound, but she's in a better place.

I will continue using some of the products I mentioned even though my wounds are healed to prevent them from opening I wish I could help all of you to help heal those damn wounds I know it is not easy my heart is with you guys.

Oh I always found a cream on line called hd scar solution I read great views on it I will be getting medihoney soon to see if it helps with my scarring.

I hope this helps anyone reading this at some point...my god bless you all..

quadyame

Hi, Matt32 I'm Tim quadyame One more thing Dr. Dixon owner of Progressive Doctors makes a prouduct caller Durma Wound this is used to heal bed sores or ulcers. He gave me a web page it's Tim.progressivedoctors.com Durma Wound works a few things it dose fights infection, debrads old tissue, and juivanatetes new tissue and much more. Well Johno I hope this helps you, pls. let me know.
Tim quadyame

Diapulse

Matt,
I'll reply to you, and to Learning1. Some people do report success with hyperbaric. That's why I mentioned it. It does help heal wounds with oxygen. Whether or not it heals pressure sores, is relative to how each person reacts to the treatment. It obviously works better on some than others. My point was, it's not available everywhere, it's very expensive to use, and it has side-effects and contraindications for some people. Diapulse also works with oxygen. The increased blood circulation, resulting from the treatment, causes oxygenation of the tissues in the treated area, which greatly expedites healing.

Learning1, you use the word frequency twice. I'm not sure what you mean by "non-frequency based." Diapulse operates on a frequency of 27.12 mh, same as a ham radio. Remember, this modality uses pulsed radio waves. Also, it operates at "High Peak Power," with the highest frequency of pulses being 600/second. As far as frequency of use, any modality works better when used "frequently." Diapulse recommends BID as a standard treatment. TID for severe wounds.

Globalwoundcare

I noted someone making a comment about Dermawound. I use it everyday in my wound care center. I like it very much. I do not use it on every patient and those that I use it on, I may not use it every visit. I may use a different medication on the same patient's wound ever visit. What I use depends on how the wound presents!!!! Admittedly, I do try to stay with the same product if it continues to improve the wound. And I do use a lot of Dermawound. It is not just for infection or significant bioburden, it also changes the PH of the wound bed, and as Dermawound dries, it draws on the wound like an old time poultrice. i think that drawing actually enhances angiogenesis (growth of new arteries) into the wound bed. Just my opinion.

I also like hyperbaric oxygen therapy. The problem is that most of the wound care centers in my area who use it, do not have a wound care physician who knows how to properly utilize it. A good comparison is Regranex. Regranex is a growth hormone that is used on stubborn wounds. It is very effective-WHEN USED CORRECTLY. I have had more than one patient come to my office complaining that Regranex is worthless and find that they have been applying it over a thick eschar (scab), under the direction of their medical doctor who did not know any better. Many doctors know how to treat a sore throat, but when the sore throat does not get better, you seek out a doctor who specializes in sore throats. The same should be done for chronic wounds. All doctors should know some wound care, but a doctor certified and specialized in wound care is who you should be seeing for a non healing wound.

Even all wound care doctors are not equal, but at least they should have more experience and provide more options than some family practice physician, vascular, general, or a plastic surgeon filling in at wound care center. If a physician wants to do quality work in wound care, they will be certified or working toward being certified. If they are not certified in WOUND care, why not? Are they there for your benefit or shopping for new patients for their practice.

I have recommended nitroglycerin paste on this chat line several times, has anybody out there ever tried it?

Learning1

Matt32,

You might be interested to know that the principle behind Diapulse, a non-frequency based pulsed magnetic therapy, seems to work well, but the key to its success is frequency of use. There are a number of documented testimonies with Diapulse. But it sounds like even a much smaller, less expensive, option accomplishes the same results. Luminita has been trying a little hand held pulsed magnetic device made by Sota (http://www.sotainstruments.com/), called a "Magnetic Pulser". She says that her bed sores, which she has had for 5 years, are finally going away. And by comparison to the expensive commercial units, the retail price is only $325 US, and one place (http://www.braintuner.com/magnetic-pulser/) sells it for $292.50 US.

Matt32

Diapulse,

In your last post, you mentioned hyperbaric treatment for pressure ulcers. I can tell you after talking about all the treatments I had with a nurse prior to me seeing the wound care physician for which said nurse works for, she told me point blank that when it comes to hyperbaric treatments for pressure ulcers, don't waste your time or your insurance company's money for it cause it doesn't work on pressure ulcers and this is a nurse who has been in the nursing profession well over 30 years. Matter of fact, I went through 3 months of hyperbaric treatments(from February 18 to May 2, 2008) and to this day, I'm still dealing with this thing. Unfortunately, a month ago we had a mishap with the wound vac I was on and it caused a major infection. The wound was almost healed the way the doctor wanted it and BAM!, all the months of hard work he put into it went down the tubes because of the vac.

quadyame

Hi, Matt32 I'm Tim M or quadyame, I have a Dr. that was so inpressed of what I found it's call Derma Wound made by Dr. David Dixson. My Dr. saw how well it works he started many others on it. So Dr. D,D GAVE ME A WEB PAGE so I can help others it's Tim.progressivedoctors.com and Progressive Doctors LLC. is his Co. Wound vac, Regrainex, Skin flaps cost so much or to much. DermaWound fights infection, debreads, rejuvinates new tisu, and much more. I had my wound about 5yrs. I had other wounds and they are closeing.
Matt32 good luck Tim or quadyame

Diapulse

You don't say what part of the US you live in, but in some areas, there's a modality called the Diapulse. (Not diathermy) It's FDA approved since 1984 for wound healing. It's Pulsed, Non-Thermal, High Peak Power, Electro-Magnetic Energy. Google "Diapulse" to learn about it. Nothing heals pressure sores faster except, MAYBE, hyperbaric chambers, and they're not available everywhere, they're very expensive and they have contraindications and side effects. Diapulse has no contraindications, no side effects and has never hurt or injured anyone. It may be used adjunctively with the traditional goops & gops and you can treat directly through dressings, clothing and casts. You may also treat directly over the spine. A doctor's prescription is required.
john_diapulse_texas@tx.rr.com

Learning1

One interesting article on wound healing, in a naturopathic magazine, went into how sugar works for wound healing, and mentioned the numerous cases where sugar was used, and alternatively where honey was used the same way:
http://www.naturalnews.com/z026812_sugar_antibiotic_honey.html
It is an interesting read, and may help some people, since some of the cases which recovered were pretty severe.

Globalwoundcare

We use a fair amount of Manuka honey in our wound care. You can do a search and find out more about hiney and wound care.

You can not use just any honey. All the honey we use is from New Zealand. Some honey has bacteria in it that may be harmful to wounds, so only use honey approved for wounds.

We have tried a variety of honey products from New Zealand, some are better than others. I have liked all the ones I have tried.

Learning1

Globalwoundcare,

Thank you for the comment. I've simply shared what I've learned of the theory behind electronic medicine (from the scenar and laser side), and applied it to what I've learned as I went looking for information to help a friend who has a SCI. Along the way I ran across information on pulsed magnetic therapy, as well as scattered research into applying these technologies to SCI related issues. From what I've seen, it looks like there is a lot of promise for use of these technologies. The promise is there for helping recovery from pressure sores, and also for going beyond this.

These technologies seem to add an additional set of tools that should be able to help awaken dormant neurons, to lessen the binding effect scar tissue seems to have on neurons forming connections past injury sites, and if the right combination can be found, it should even be able to help trigger the body to change some of this scar tissue into embryonic like tissue. If this type of change can occur, with the appropriate stimulation it should be possible for the body to then regenerate neurons and create connections to areas where senses and movement have not been felt or experienced in years.

Globalwoundcare

Learning 1, maybe you should change your name to teaching 1. I know I have learned much from you.

I want to mention another point about using new products. I am testing eletric bandages in my offices. The bandages are removed and cleaned twice per week and re-applied. My staff does not like the electic bandages and my other doctor agrees with my staff-they are all wrong. They do not like the bandage because they have seen increases in wound drainage and slough on the wound bed.

What they are missing is that the reason we are seeing more exudate is because we are seeing more activity in the wound bed.

I am not saying I am sold on electric bandages, I am still watching. But going back to what Learning 1 said about new products, sometimes the person testing the product needs more education on how to use the product.

ALL OF YOU OUT THERE WITH PRESSURE SORES, PLEASE, PLEASE TRY NITROGLYCERIN PASTE AROUND THE WOUND. If your systolic bp is over 100, you should be able to tolerate 1/2 inch tid around the wound-REGARDLESS WHAT LEVEL OF WOUND. It is great to help prevent full tissue breakdown. Regardless if you have an infection.

Learning1

Globalwoundcare,
Thanks for posting the backround information on pressure wounds.

For the benefit of the others who read this, there is also a good description of some of the challenges with pressure wounds / pressure sores in PN Paraplegia News (http://www.pvamagazines.com). And there is also a good description of a study by the NYU school of medicine which describes what appears to be the technical cause, at a cellular level, behind pressure sores, under the title "Researchers shed new light on cause of bedsores and other chronic wounds" at"
http://news.bio-medicine.org/medicine-news-3/Researchers-shed-new-light-on- cause-of-bedsores-and-other-chronic-wounds-9299-1/

You mentioned that a physician you knew had "unfavorable results" with the Diapulse before, and had been approached by them to do another study. As you mentioned, there are a lot of factors involve in pressure sores. I suspect that these impeding factors need to be elminated before a true judgement call of "unfavorable results" is made.

Going beyond this, anybody trying something like magnetic pulse therapy has to remember that for any form of electronic medicine, there is and has to be a different outlook or perspective taken. The various versions of electronic medicine (scenar, laser, magnetic pulse therapy, electronic stimulation, etc) all approach healing differenty than traditional medicine. The concept with these tools is to help the body work through its natural healing reaction and to complete the healing process, but doing it in a less damaging and more controlled method, eventually helping the body to getting to a position where it is able to immediately deal with situations as soon as they begin to arise, rather than long after it becomes a problem. Traditional medicine uses drugs and other methods which may actually stall or stop the healing reaction part way through in an effort, getting the body to a point where the body never gets to healing the area, and all that is done is a regular control of symptons. When this happens, the body eventually gets to a point where it ignores the problem to conserves its limited energy, and use it for other apparently more pressing needs, places where it thinks more benefit can be gained.

The best description I have seen of how the body reacts and works through problems (the process which called adaptation) was in a training video done by Dr. Irina Kossovoskaia, a former Russian eye surgeon, who is now a naturopath in Canada, and does a lot with Scenar, Cosmodic, and lasers, and does a lot of instruction with those. She points out that one of the keys for the body's dealing with any disease or similar problem is the process of adaptive reaction, and the faster and more completely the body reacts, the less challenging the problem is to overcome. One of her examples is a simple saph infection. If the body responds quickly to it, damage is limited and the body quickly recovers. If the body's response is slower and less effective, the same bacteria can cause the flesh eating disease. A brief part of her explanation is at: http://dririna.com/posts/view/SCENAR__How_It_Works.html, and some information is also at: http://www.neuropaths.com/index_files/SCENARTheory.htm, and at: http://www.scenarhealing.com.au/A%20deeper%20understanding%20of%20SCENAR%20 therapy.html.
The person it sounds like she learned the principle from was a Russian neurologogist, Dr. Alexander Revenko, who came up with many of the techniques used in Scenar technology (adapting many of the ideas from eastern medicine - things like acupuncture and associated treatement methods, seeing these things through the eyes of a leading edge neurologist.

And any time energy medicine is used, the status has to be understood. Is the body currently ignoring the area? If so, either a form of simulation that calls the body's attention to the area (like Scenar) has to be used, or something may have to trigger the body's attention, like the area actually appearing to get worse. If the process is interrupted at that point, the healing reaction may be interrupted, and benefit lost. That happens with scenar and with laser, and I suspect is also the case with pulsed magnetic therapy.

Next, I'm not sure why, but I read a comment in one place that says that if a sore is new, using strong pulsed magnetic therapy may aggrivate the situation. It sounds like a more calming influence may be needed at that time - something to get the blood flowing to the area, but more calming than stimulating.

And I suspect that pulsed magnetic therapy, like the Diapulse, probably works similar to laser and scenar. If used too much in normal circumstances, and too much energy is added, it can stall progress also. Dr. Lytle, when talking about the amount of energy to use with lasers (in his Healing Light seminar videos) describes it as being like a bell curve, where when you begin to add energy, the benefits increase to the point where you get to the top of the curve. As you approach the top, the extra benefit declines. As you go over the top, benefits begin slowly being lost. And he longer you go after that, the faster you lose the benefits you thought you had gained, getting to the point where you end up where you started. No actual damage done, but no progress. And the reverse is also true. If treatment is too infrequent, you may also see little if any benefit. It sounds like for a lot of conditions, you need to get to a critical mass before you see anything beyond very short term results, or results at all (since it may take going for a period of time, on a regular basis, to begin getting results).

So there are a lot of things to consider when trying to determine whether a form of electronic medicine is beneficial or not. A lack of results may come from not learning the factors involved. Or it may be due to other impeding factors, like the ones you mentioned.

By the way - one other treatment method I've heard fo for pressure sores (one not related to electronic medicine), which has apparenlty been around for many years, is something that it sounds like some of the naturopaths suggest trying. Their suggestion is to put honey on the wound (sounds like it is spreading it on the bandage, then putting it on the wound), and changing the bandage every day. I'm not sure what type of honey they suggest (i.e. natural or pasturized, etc), or the logic, but it apparently helps trigger the body's natural healing.

Globalwoundcare

Let me make another comment regarding "energy". I know when I am treating an ischemic wound (poor arterial flow), I am careful about how much I debride at one time. It is a common mistake to over debride and cause more necrosis (tissue death), because the body does not have sufficient circulation or "energy " to heal more trauma to the area. One of the reasons why my wounds do better than most others, is because I debride a little at a time (when I have a choice).

If I have a bad infection, I am forced to remove as much dead tissue as I can, as the antibiotics do not circulate through dead tissue and you need to reduce the infective influence.

There is always bacteria on a wound, you try to maintain a balance. When you see your wound is not responding, you need to determine if it is circulation or over abundance of bacteria. Don't misunderstand me, there are other influencing factors as well, but hopefully they have already been addressed.

I am talking about what is called bioburden. The wound may not necessarily show the typical signs of infection and still need antimicrobial therapy (topical, IV or oral). Frequently saline, acetic acid (well diluted) or dakins solution may be used to reduce the bioburden topically. I have one patient we are treating his psuedomonas over growth with gentamycin topically. He shows no infection outside of the wound, so we are not putting him on any systemic antibiotics. I have been known to treat with both oral and topical for bacteria overgrowth with out infection. Because of events in this particular case I have elected not to place him on systemic antibiotic.

Energy in the body is regarded much like the "soul" and frequently not given nearly enough consideration.

Globalwoundcare

I spoke with a physician yesterday. He said that he has been contacted to do a study and I think it is on the Diapulse. He said he had unfavorable results in the past, but had been asked to look at it again.

As for me, I am still looking and listening.

Learning1

Globalwoundcare,
I ran across a health care provider who now covers pulsed electromagnetic therapy for treating pressure sores. There are probably others also. See: https://www.oxhp.com/secure/policy/electrical_stimulation_wounds_1208.html
Diapulse is the company that asked them to cover, and they releted. There were apparently 10 studies out there that were cited. It sounds like they were still skeptical, but eventually agreed.

A portion of Laurence Johnston's site, that deals with some of the Diapulse results (at http://www.sci-therapies.info/Electromagnetic.htm) is interesting:

"Pressure Sores: A number of studies demonstrate that Diapulse treatment greatly accelerates the healing of pressure sores, a serious SCI-associated problem. In a specific SCI-focused, double-blind study, Dr. C. A. Salzberg et al (Valhalla, NY) showed that the pressure sores of Diapulse-treated patients with SCI healed on average in 13 compared to 31.5 days for controls (Wounds 7(1), 1995).

The following case study, reported in PN/Paraplegia News (September 2003), is indicative of Diapulse’s potential for treating SCI-related pressure sores:

“My husband is a T8 paraplegic. In 1996, he developed a severe decubitus ulcer of the coccyx, and it progressed to stage 4 (i.e., into the bone). Although he had home health care for almost three years, the wound continued. Health-care professionals took the approach of packing and probing with no success. Finally, a new wound-care specialist took time to do a lot of research and came up with the idea of using Diapulse therapy. Medicare refused to fund the cost, but our supplement paid the cost for eight weeks. The wound was about four centimeters deep and quite large in diameter. It was absolutely amazing, after eight weeks of four-times-a-day therapy, the wound healed completely. It is indeed a miracle cure."

At least in some situations it seems to have made made a difference.

Luminita, from Romania, is trying a little magnetic pulser on her pressure sores. She says she will report on what happens.

Globalwoundcare

I have been looking at the electric bandages. Several different types are out there, none cheap. I still wish you would talk to your physicians about nitroglycerin ointment. It should be available anywhere in the world as it is typically used for heart attacks. It is not very expensive and it helps bring blood to the wound. More blood allows the body to get medications and other nutrients to the wound area. I usually prescribe 1/2 inch to be rubbed in around the wound three times per day. I recommend not using it at all if your systolic blood pressure is less than 100mmhg.

Learning1

The challenge is coming up with a solution or method that works for you. In the western world, there are a number of options. Lumintia in Romania doesn't have many options.

What has been shown in a number of devics is that, although surgery, the vac systems, etc, all sometimes work, there seems to be a concept beyond what traditional doctors have been trained in which in the past has not been considered. Part of what the body needs in any wound healing is energy to the cells.

Traditional medicine looks at one method only - the food energy supplied by the blood stream. When the circulation to the area is restricted, like occurs through prolonged sitting, especially on improperly designed cushions, blood flow can be cut off, ultimately resulting in the pressure sores. Hence the traditional treatment of staying off of the area, better cushions, etc, which is aimed at helping restore bloodflow. Then traditional medicine tries to prevent germ growth, since germs will cause an area to fester.

Energy medicine looks at things a bit differently. First, it tries to restore the cellular energy, and in addition to the blood flow (which is necessary for cellular improvement), different methods add electrons to the area. Physics shows that when electrons are added, molecular PH changes. This changes the PH of the area. If the cellular PH is greater than 7, bacteria doesn't grow and prosper. And cellular recovery occurs best with a proper PH. As well, some forms, like properly used laser, appear to either neutralize or chase away bacteria, in addition to improving micro circulation to the area, and improving lymph drainage. Things like the vibration plate therapy help the immune system clear itself, and I suspect that to some degree the magnetic pulse therapy probably also does some of this. And as cells are properly polarized, they heal faster. One old method, which many forget about, and given the locaton of pressure sores may be a hard one to impliment, exposure to sunlight. Even that, over the years, appears to have added energy to the area, and has apparenlty helped speed healing of some problems.

Ultimately, though, each person is responsible for her or her choices. Gadgets can help, but each has its limitations, and some may not be available in an area.

Matt32

Wow, I can see there's been alot of discussion on this since I first posted it. At least we are all getting together on here trying to come up with certain ways of healing things. As for me, the discussion about any new ways of healing didn't come across with the wound care physician as I had hoped. He had other plans, which involved me staying in the exam room for nearly 2 hours while he brought in someone from California who is an investor in products such as the wound vac and instead of us asking all the questions, this representative asked them about me starting of course with "How long have I had the wound?"

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