My patient suffered from a wound tunnel of more than 6.5cm in length.
I have been treating him using mesalt for more than a month and there is no sign of the tunnel healing. In fact the condtion is much worst, it was less than 5cm one month ago.
The hospital have issued my patient with antibiotics but the medication does not seem to do anything. The doctor simply told him to wait for the flesh to granulate, but unfortunately it does not.
1. what other products should I use?
2. what other better treatment option is there?
3. should I advise my patient to go for MRI scan?
4. what are the chance that he would have to go to another operation, I have been seeing this patient almost twice a week for more than 4 month, and everytime he is in pain, cant really bear the pain if he have to go to another ops.
5. is there anything that can help speed recovery, I already recommend he get zinc + vitamin C tablets and he is also drinking at least 2 glass of milk a day.
Considering it is not infected, it is safe to assume the antibiotics are doing what they are supposed to do. I would remind the MD, dietary and anyone else you can of the situation and document that.(cya) It is interesting Dietary did not order vit-c and zinc from the start. What is the actual depth of the wound?(not the tunneling) I have noticed in the past that for some reason tunneling can heal alot slower than depth even with a wound vac. I dont know why. I have used wound vacs and they are absolutely incredible for healing. I currently have a stage 4 in the coccyx area with ALOT of tunneling. We flush with 120 mL of NS and pack it with wet to dry tid (clean not sterile), give vit c and zinc and do nothing else. (lots of prn pain meds of course) Even though the tunneling has not decreased the wound has become very clean and healthy looking. that is typical of what we do for most wounds of that nature.
I came back to edit this and add we also give Prostat and Ensure bid. One last thing. Did you do the original measuring of the wound a month ago or did someone else? I regularly measure a wound and find that the other person/people doing it is not accurate with their observations. The first person gets it wrong and everyone seems to stick with that until someone comes along and corrects it. The first time you measured it was there a big difference between yours and the original nurses measurment or has it been gradual by YOUR measurements?
Last edit by nursenow on Aug 24, '10
To be honest i talk to him about food, he ate fish, pork, chicken, lots of veges and fruits, he claim he ate at least 4 servings of fruits and 4 serving vege per day. One whole kiwi is one serving for example. He also have 2 glass of milk, drinks lots of fruit juice (various types), he also have bottle of essense of chicken daily, and a glass of milo daily. I dont think protein is a problem.
He also take Shen yu, I dont know the name of the fish in english (not raw fish), chinese typically take it when recovering from injuries and yes it is known to speed up recovery by more than 25% most of my relatives and friends swear by it. To be honest all other nutricient supplement effectiveness depends on person to person, but Shen yu effectiveness is like work for everyone except if u allegic to seafood. Ask any chinese what to eat when injured they would tell u 3 things chicken essense, shen yu and yunan baiyao, although some would say tian qi. I note sure about chiense medication but I heard from ppl yunan baiyao can work wonder but I dont trust china products so I never recommend to my patients. But some of my patient told me they use the product with good effect. There are 2 kind one for internal and for external, I advise against the external one as it may impaired our wound treatment process.
Zinc maybe a problem, since he is chinese and all chinese seem to avoid beans, nuts, and all seafood except fishes , when having open wounds.
The reason is these food contain either poison (not the poison that can kill) or is more likely to be infected or cause infection. As for why we are not sure. Some even go to extend to ban managoes.
This is why I recommend him get zinc pill, but then again even blood test (done b4 he took the pill) show no sign of zinc defincientcy but never the less I ask him to take. But then seem like zinc does nothing much, he only claim he sneeze less.
Last edit by fiffy on Aug 24, '10