I have had a stubborn pilnoidial cyst wound that will not close up I have been operated on at least 5 times the last being a flap z-plasty which was done several years ago. however i have this wound that measures 2.5x3.5x4.4 in depth that has again been opened now fpr the last 3 months, we have tried aquacel, and now mesalt but neither is helped close the wound in fact i think it may have gotten worse. the latter we have been using for the last 3 or so weeks. i am wheelchair bound so i have been trying to stay off my butt as much as possible but it is hard when you use a chair to get around. we have also used the silver impermeated stuff also to no avail, my question is what should be the next step? My wound care nurses are at their wits end, i was thinking maybe a wound vac but the one nurse who also does my ostomy issues said that she does not have much luck with them in that area in a home care setting. Please help me i am about ready to give up i must also add the last time it was cultured it had MRSA in the wound.