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Hi everyone, my brother-in-law recently had a minor stroke and became bedridden. He got a large bedsore on his left thigh (between knee and hip). Now he is just discharged to a nursing home and hooked with a wound-vac. I wonder if anyone has experience on this problem. Thank you.

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Yes. I am a retired nutrition counselor. Wound vacs help with healing difficult sores. A dietician will also supplement the diet to add protein for healing. This is actually good nursing care.
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Freshi Oct 2022
The hospital provided the wound-vac equipment. This NH doesn't have one. So we have to go there everyday to make sure the vac is used properly (not pulled off, not being pushed against the floor, not being used for too long without changing the dressing, etc.) and to make sure he eats properly.
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My wife was fighting a very bad rash that covered her entire back for 6mos her doc and the er had no clue and gave up. I found a dermatologist who did a biopsy’s (still don’t know what it is). He prescribed a cream (steroid) and within two weeks it was clear. Everyone was surprised. She is bed ridden and lies on her back, first thoughts were a fungal infection but they were wrong. If there are skin issues find a dermatologist
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Freshi Oct 2022
Thank you for the advice.
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I have experience with a wound vac on a flap of skin that had to seal on my back due to an operation on my lung. even though the skin was fairly loose, it did not heal the way the doctor described and left my with a itchy depression. I told them it needed to be sewn up, but they insisted on the wound vac....
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Freshi Oct 2022
orange46, thank you for sharing.
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Freshi: Per Google: (disclaimer - not my authoring) "A wound vac is a treatment that helps wounds heal faster. “Vac” stands for vacuum assisted closure. The treatment uses suction, like a vacuum cleaner. This pulls fluid out of the wound and holds the edges of the wound together. It also helps blood to flow to the wound, which helps it heal."
I do not have personal experience with this device, Freshi.
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Freshi Oct 2022
Yes. The hospital provided this equipment and is being used for his bed sore. Thanks.
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I am a registered nurse. Wound vacs are wonderful devices. They allow wounds to heal from the bottom up. They work well as long as they are hooked up to power and the suction is working. The wound care nurse will evaluate and change the dressings - usually weekly.

Your BIL will heal better if he turns every 2 hours. He will also heal better if he gets adequate nutrition, fluids, oxygenation, and circulation. Some of those are easy for staff to implement. Some are more difficult based on your BIL's health and his chronic health problems.
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FYI: copy and paste into your search window

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/vacuumassisted-closure-of-a-wound
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Freshi Oct 2022
Yes. He is using the wound-vac right now. Thanks.
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Having posted once on this subject, here are some other things to consider for patients who are bedridden. Get an air circulating mattress. It helps prevent constant pressure in the same spot. Frequent turning will help. If you notice a really red skin area this could be the beginning of a bed sore. If one takes action this spot should not get worse but return to a normal appearance. Hope these observations help.
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My husband is in an Adult family home and developed a sore on his lower leg. That used a wound vac on it for at least a few weeks and also give him two protein drinks (30 grams/11 oz)daily to help the healing process. ( the drinks are not cheap...best deal I could find was at Costco...premier protein brand)
Good luck!
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Freshi Oct 2022
We'll buy it. Thank you.
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Johns Hopkins sent a mobile friend home with a wound vac. I figured they knew what they were doing but was still a little skeptical because the premise is weird (leave the wound open but pack it with sterile something (???) and suction out moisture — and be patient, cuz it’s a slow process) but it’s an amazing piece of equipment. It’s obviously a little inconvenient since you’re attached to a device but nurses changed the packs and it’s a holistic solution that lets the body build layers of new tissue to fill an open wound. No side effects.

Why not give it a chance and see if the wound starts healing?
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Freshi Oct 2022
Yes. He is using it everyday now. Thank you.
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Ask if they can treat with oxygen. My mil had a sore on her ankle. Daily we hooked up oxygen to a bag that went over the ankle. It closed up quickly. Medicare did not pay. At the time it was a one time payment $500 until the sore healed.
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Freshi Oct 2022
We will ask. Thank you.
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I was told by a nurse that two things that cause bed sores are pressure and moisture. If one can be eliminated the wound can begin to heal. I used Calmoseptine cream on my wife's tailbone wound and got immediate results. The cream has zinc oxide in it which prevents moisture reaching the wound. At the same time try to reduce pressure on the wound. The nurse said he had seen the cream work on wounds where the bone was exposed. I put this cream on my wife after every diaper change. No bed sores in over two years bedridden.
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Freshi Oct 2022
Ordered it. Thank you so much.
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The wound vac didn’t end up working for my dad (his pressure ulcer was on his tailbone and he eventually had to have it addressed surgically, which was successful) but the really great home health nurses who did wound care for us were very enthusiastic about it and had seen it work wonders in other patients.
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Freshi Sep 2022
Thanks for the info. We requested surgery when he was at the hospital, but they said not for him.
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I'm not a fan of the wound vac for a bed sore. I've had invalid clients who had to have one. They developed tunneling bed sores from incontinence and lack of repositioning. No one was caring for them properly and their hygiene was severly neglected.
If the sore on your BIL's leg has not tunneled too deeply it can be healed by changing the dressing daily and using (this is going to sound strange) medical honey and being packed with fiber containing it. This works greater than topical antibiotics. If it's kept clean and the pressure can be kept off it, it will heal.
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Freshi Sep 2022
[medical honey and being packed with fiber containing it] this is something new to learn for me, will try. Thank you.
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Just an add on--if the patient is very heavy, the wound vac works, but has to work 'against' the weight of the skin surrounding the wound. I knew a man who was probably 350(?) lbs and when he had back sugery, his wound would NOT close up. He was given a wound vac and had it on for almost a year. I had the same back surgery as he did and was walking around within a week. I'm not skinny by any standard, but being a 'normal' weight made it so my skin closed up well.

Make sure the patient is eating lots of protein. But not sitting around eating all day. Last thing you need is for that woundvac to fail on you b/c the patient gains weight!

Good Luck!!
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Freshi Sep 2022
very helpful. Thanks.
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The lower back does not have enough tissue the reason its hard to heal. But like said, the position of the wound there is tissue so with proper attn it should heal well.
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The fortunate issue here is the position of the bedsore. My mother at 92 has had one on her lower back for over a year. A series of unfortunate incidents led up to this. It has improved considerably since it was at its worse. Fortunately she is now at a much improved facility that is working even more diligently on it
It took some time for a bed to open there.

It is most important that dressing is changed daily on the bedsore. A wound vac machine sounds promising. My mother could not lie on a machine. Constant communication with the facility is important. You should try to find out weekly how it is progressing.
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Freshi Sep 2022
【 Constant communication with the facility is important.】yes, we found out that too. Thanks.
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Great that he is getting wound care at the NH. As said wound vacs help to heal it. My daughter did woundcare.
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Freshi Sep 2022
Thanks. The nurse at NH will come once a week.
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Freshi,

I'm sorry to hear of your BIL having had a disabling stroke. This is an unfortunate turn of events in anyone's life and in the family's who love them. I hope for his reaching full rehab potential and being able to return to a modified - independent life outside of a SNF, if this is an achievable goal.

I'm a retired RN and always worked diligently to prevent skin breakdown that results in bed sores. They are pretty slow to develop and take time to heal. For any family able to be with him, make sure that he is kept positioned with pressure off that wound site and don't feel intimidated about asking for cares or obligated to accept any below-par care provided for him. Don't be afraid to ask questions and gently but firmly advocate for him in all aspects of his care.

Wound Vacs are awesome and truly do aid in healing wounds by providing constant stimulation of blood flow and by wicking excess moisture and bacteria away from the wound while protecting the delicate healing taking place at the edges of the wound. Hopefully, the size and depth of the wound will continually decrease as healing takes place. The 'dressing' is changed every 3-5 days, as I recall, and it's key that the adhesive is fully attached to ensure the proper function of the Vac.; This is among the things that family can check on, as well as ensuring proper positioning, movement, nutrition with high protein (unless contra-indicated by other medical conditions) and hydration to promote healing.

If rehabilitation and a return home is a realistic goal, the encouragement of loved ones helps in large measure to provide the support and encouragement needed to reach every goal. Family also knows the personal needs of their loved one and if communication is impaired, can help him to voice his needs.

I wish your BIL, you and yours the best.
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Freshi Sep 2022
Thanks. my husband goes to NH everyday to check on the vac.
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