Wound VAC Prompts Healing Of Hip Infection

Specialized in-home treatments help close seeping pressure ulcer.

More than a third of the 20 years that Judy* spent as an Air Force nurse were abroad, in faraway places such as Thailand, Turkey and Europe. Judy says she learned a valuable life lesson during those extended stays.

“I learned that God doesn’t have favorites,” Judy reasons. “The whole world is beautiful, and everywhere you go, there are very nice, very funny people who care deeply for one other. Though we speak different languages, we’re all pretty much alike.”

The daughter of a St. Augustine firefighter, Judy joined the service in 1964, four years after graduating from nursing school. She retired in 1984 at age 45 and continued devoting much of her time caring for others.

“I retired to Panama City but moved back to St. Augustine after five years to take care of my mother, who was diabetic,” Judy explains. “After that I got deeply involved in church work. I also raised four dogs, all Dachshunds. They were my kids.”

Now 83, Judy often finds herself surrounded by children, the offspring of her five siblings, several of whom live near her in St. Augustine. That’s a good thing, because there was a time not long ago when she suddenly found herself badly in need of their help.

“It started when I decided that instead of taking a shower, I was going to relax and soak in the bathtub for a while,” Judy explains. “The problem was that when I tried getting out of the tub, I couldn’t. No matter what I did, I could not lift myself out of that tub.

“It was a horrifying experience that lasted for four days and four nights. The only way I survived was by drinking water out of the tap. Finally, after four days, my family finally came to check on me and found me there still sitting in that tub.”

After her rescue, Judy spent a few days in a hospital, then two weeks rebuilding her strength at a rehabilitation facility. That’s where a family member noticed that a bruise had formed on Judy’s left hip.

By the time Judy was released from rehab, the bruise was causing her pain whenever she walked. Then, over the next two weeks, the bruise turned into an open weeping wound that clearly needed medical attention.

That attention was initially provided by Judy’s primary care physician, who arranged for treatment through a home health care provider. Almost immediately, the home health nurse sought help from the wound specialists at Advanced Wound, Ostomy & Continence Care.

50 Years of Experience

The four advanced practice nurses at Advanced Wound, Ostomy & Continence Care boast more than 50 combined years of experience in providing wound care, ostomy care, dermatological care, continence care and patient education.

“We are a patient-centered practice that uses evidence-based modalities in the treatment of our patients,” says team member Kristi Lord, DNP, MSN, APRN, FNP-C, CWS. “We treat venous leg ulcers, diabetic foot ulcers, pressure ulcers and all other kinds of wounds.

“There is absolutely nothing on your body that we won’t try to fix if it has something to do with the skin or excretion. I say that because wounds and excretion are correlated. If you don’t properly rid your body of its waste, your wounds are not going to heal, or you’re going to get wounds you didn’t have before.

“I can’t say enough good things about Kristi and the great work she did for me.”- Judy

“Our goal is to help people live comfortably and, in terms of our continence care, we mainly instruct our patients how to improve that issue through pelvic floor exercises, therapy and education.”

When Kristi first visited Judy, she knew immediately that Judy was dealing with a deeply infected pressure ulcer. After hearing Judy’s story, Kristi concluded that the roots of the ulcer formed while Judy lay stationary in the bathtub.

“It initiated underneath the skin from the bone pressing into the tub,” Kristi reports. “That compressed all the tissue between the skin and the bone in a place that Judy couldn’t see, which is how a lot of pressure ulcers start.

“At the rehab facility it appeared as a little red ring on her hip that no one paid much attention to. But over time, the ulcer festered and brewed and started eating away at the tissue underneath.

“By the time I got to it, it was a smelly, goopy infected mess, and it was big. It was about two inches long, an inch wide and almost an inch and a half deep, so it was a rather severe situation that we were dealing with.”

Kristi began her care of Judy’s wound by performing several debridements, in which healing is promoted through the removal of dead, damaged and infected tissue. She then ordered an x-ray to determine if Judy’s hip bone was infected.

The x-rays came back negative, but Judy’s complaint of pain in her hip while walking convinced Kristi the bone was infected. With that in mind, Kristi prescribed a two-week course of oral antibiotics.

The medication did little to heal the wound and the pain remained, so Kristi sent Judy to an infectious disease expert, who ordered an MRI. The MRI confirmed Kristi’s suspicion that Judy’s hip bone was infected.

Closing Time

Following the confirmation, Judy was placed on intravenous antibiotics to ensure the medication was going directly into the bloodstream. That and a series of treatments using a wound VAC sparked the healing that Judy needed.

VAC is an acronym for vacuum-assisted closing, and wound VAC therapy is “exactly what it sounds like,” Kristi educates.

“I put a sponge on the wound and hook a vacuum hose to it that sucks the drainage out of the wound and deposits it into a teeny-tiny canister. At the same time, the vacuum pulls the edges of the wound together, which helps to close the wound. The vacuum is in a bag that the patient carries until it’s no longer needed.”

Judy received six weeks of wound VAC therapy. During that time, the wound closed and the infection cleared. Judy is now walking and exercising without hip pain, and she gives the bulk of the credit to Kristi and her treatment approaches.

“Kristi is terrific,” Judy enthuses. “She knew exactly what was happening with that wound, and once she got me on the IV antibiotics and put that vacuum on it, that really sped up the healing.

“She also put a skin graft on the wound to help fill it in. I can’t be more pleased with the treatment I received from her. She did a great job and kept everyone in my family informed about what was happening, which I really appreciate.

“I can’t say enough good things about Kristi and the great work she did for me. I feel very fortunate that I had her on my side during this. Who knows what would have become of me had she not come along to take care of me.”

© FHCN article by Roy Cummings. mkb
*Patient’s name changed at her request
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