easy question? then some

  1. I have a question, almost feel silly asking it. I have a patient that has a wound on either the sacrum or the coccyx. it seems the wound clinic puts either or. does it matter? can you really tell the difference? it is really just maybe an inch above the rectum.

    Plus this wound is just horrible. This patient had an implanted radiation device over 30 years ago that has been removed but caused a horrible almost 'calloused' area above where the Stage IV is now. The wound now tunnels everywhere and has huge chunks of bone falling out. The wound clinic is having us pack it with nugauze, cover with Ca alginate and the 4x4 and papertape. it kills me each time when I pull it out to pull big pieces of bone out. pts been to a plastic surg, and an ortho dr, they have said they cannot do anything? is there really anything else that could be done? or that would "help" this patient? she has bad alzheimers and really c/o of no pain. any suggestions? anything at all on what we should do for this patient, she is a home health patient?

    thank you! if ya can help at all...or any words of encouragement
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    About bebop1

    Joined: May '05; Posts: 77; Likes: 12
    Home health RN


  3. by   deeDawntee
    Oh my God, you have got to be kidding! That poor patient and my sympathies go out to her caregivers as well. I don't know that with a wound that huge that it really matters if you call it the coccyx or the sacrum because it encompasses all of it...

    I don't know what to tell you, I would be crazy for some help or some answers for that patient as well. It would be absolutely unbearable to keep doing dressing changes with more and more bone crumbling from the wound and know it really isn't making much difference!! You would have to imagine that eventually an infection will cause death.

    Thank God there are nurses like you with compassion and concern that go way beyond the norm. You are truly a hero...

  4. by   sharlynn
    The coccyx is the very end of the tailbone and the sacrum is the area above the coccyx. They are frequently confused.
    Measurements weren't given, but I would question how "Huge" this wound is if it can be covered by a 4x4.
    Thank goodness the patient isn't having pain.