I have a pt who is a relatively healthy paraplegic, about 55 yrs old. He has a non-healing/ stalled wound on the left buttock since October...had cyst removed late October. Wound vac placed with good, although slow, results until March. Wound vac removed, went to wet to dry dressings TID. Stalled again. Went to Dakin's Solution BID. Stalled. Added honey dressings BID. Stalled. Alternate Dakins/Honey dressings, continue BID changes. Dr is considering a muscle flap. My concern is that if we do surgery, with the slow healing we have now, if we have surgery, we'll have a larger wound that is not healing. There is no slough, no s sx of infection. MRI completed, shows bone is free from harm. I am at a loss...anyone know of dressings, additives, something to do to help get this wound headed in the right direction? I've suggested hyperbaric chamber, pt has no way of getting to the closest available for the length of time needed for successful treatment. Help!