Wound vac for butt wound

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blueglass
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Date Joined Dec 2010
Total Posts : 3332
   Posted 6/9/2011 10:35 AM (GMT -6)   
I know some of you have mentioned having a wound vac, just wondering if anyone knows anything about wound vacs for butt wounds.

My surgery was 3 and a half months ago, and the butt wound has been slow to heal (A week after I got home from my surgery, I had an abscess there and had to go back in the hospital for a few days). First I was packing the wound with silver alginate dressing, then my nurse switched me to mesalt, to dry it out more. That was working really well. On the aquacel, I went six weeks with my wound staying at 2 cm deep, after 2 weeks on the mesalt, I was down to 1 cm. She thought we could try not packing at all to let it close.

Well, that didn't work. It started draining again, and when I went in today, my nurse had a personal emergency and wasn't there, so I saw another nurse. She measured and now I'm up to 2.5 cm deep again -- it opened up and had a lot of drainage in it. Sigh.... discouraging.

So we went back to the mesalt and hopefully that will help again. But she did mention that if it's not smaller in two weeks, we could consider a week on a wound vac. It is a little unclear to me how a wound vac works in that place (where my anus used to be). I've never had a wound vac at all. How does that work with clothes? With using the toilet? Sitting down? Would I have to stay inside all week?

The wound doesn't hurt, mostly it's just annoying (and makes it so I can't swim, sigh....but tomorrow I'm going on my first plane ride since surgery!).

thanks.
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

run4pancakes
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Date Joined Oct 2008
Total Posts : 938
   Posted 6/9/2011 12:24 PM (GMT -6)   
I have no idea how that would work? I've never had a wound vac before. Maybe it's something you can take off and on? I don't know, but now I'm curious!
UC dx 2/08

Done with the drugs. Step 1 (of 3) J-pouch surgery 3/22/11, Steps 2 & 3 TBD
http://life-takes-guts.blogspot.com/

Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 6/9/2011 2:28 PM (GMT -6)   
I did have one after my proctocolectomy sad but it really isn't a big deal. Basically, they 'stuff' the area with a foam/sponge type material and attach another piece that has a hose and clear sticky material. The hose is then attached to a machine that suctions the whole thing. The hardest part for that area is a good seal...but I was able to keep mine for two weeks :-) and reduced my 5+cm abscess down to half that size smilewinkgrin and I just packed it from that point on.

That kind of simplifies the description but the machine has to keep a certain amount of pressure during that time or the whole thing needs to be changed. Depending on how far you are from your doc's office you may have to make a trip every few days or a home health nurse will have to come to your house. You can go out...I did...but not very ofter since I did have a machine attached to me shakehead

Bathroom is ok you just have to position yourself so everything flows forward...it's manageable. And sitting isn't any different than regular instructions to not put pressure on the area...still have to sit on one side or the other. I wore yoga pants mostly but you can wear whatever feels most comfortable.


Have a great time on your trip!
formally known as OHIO76 ~ honoring my daughter's passion!
Crohn’s dx 1989
some terrible years before my temporary ileo in 2001
Proctocolectomy w/end ileo in 2008
...wish I knew then what I know NOW!

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 6/9/2011 6:37 PM (GMT -6)   
Thanks EQ Mom. I sort of get it.... so you had a hose coming out of your pants the whole time?

It sounds like that would have just been one more thing in the mix a while ago, but now that I'm out and about, it'd be a bigger limitation. If it would help, I'd do it ... but I'm hopeful that going back to the dry packing will be enough.

Thanks also re the trip. It's been kind of a bad week, so hopefully things will start picking up.
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 6/9/2011 6:52 PM (GMT -6)   
I had a wound vac. Mine was on my abdominal incision which was hard to deal with because it was so close to my appliance that every time I had the wound vac dressing changed (about every other day), I also had to change my appliance. It was also extremely painful for me (especially the sponge dressing changes) which my surgeon and nurse said hardly ever happens. It just seemed to be aggravating some tender nerves. I was prescribed Lidocaine to put in the wound before dressing changes which helped a lot. I also took Vicodin. The plastic sheeting they used to tape the sponge down and keep the suction was very irritating to my skin because it doesn't breathe at all, but skin prep helped some. After I finally had the wound vac off, my skin irritation healed quickly. Leaks in the suction were annoying, but easy to fix.

Still, even with all these annoyances, I would do it again in a heartbeat. It was on my wound for six weeks and then I had Silver Alginate dressing for another week and everything healed up beautifully. I can't even imagine how long it would have taken just packing the wound.

I toted the wound vac around with me everywhere, though that might be harder with a butt wound. Not sure. I even wore it to my meditation class a few times which was funny because it sounded like a coffee percolator. The noise was so distracting that I ended up turning it off during the actual meditations after making sure it was okay with my nurse, but you can't leave it off more than a couple of hours or you have to get the dressing redone. I could still wear my clothes with it. The tube just stuck out of the top of my waistband. It basically looks like a purse and you can hide the hose (which is kind of gross because it is clear and shows the drainage) by folding it under the flap of the carrying case and then tucking some in your clothing too. I was able to shower with it on by taping saran wrap over the dressing and turning off the suction. Sleeping with it was a bit weird because you have a tube stuck to you... but the hose is pretty long so you have some leeway. One night my machine turned off in the middle of the night because I did not hear an alarm on it telling me it was running out of juice (I had forgotten to plug it in to recharge). I had no idea how long it had been off, so I had to call the nurse in the middle of the night to come and redo the dressing. Boy did I feel stupid. So yeah, it is a bit of a pain but I would highly, highly recommend it.
-39 years old
-Officially diagnosed with UC in 2006, though had symptoms since 1999.
-Had mild/moderate symptoms continuously until severe flare in autumn 2010 which required 2-week hospital stay
-Took Asacol, Rowasa, Canasa and Prednisone to manage flares but meds stopped working
-Tried 1 dose of Remicade but had excruciating joint pain and discontinued
-Had permanent ileostomy surgery 11/8/2010

Post Edited (Blueheron) : 6/9/2011 8:43:25 PM (GMT-6)


blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 6/10/2011 3:31 AM (GMT -6)   
Blueheron, thanks for the detail. You must have been glad when you were done with the vac. Good that you still feel positive about it, despite the hassles.

It sounds like both of you had the vac earlier and then switched to packing. Seems like I got a lot further along with packing .... I did ask my own nurse about a wound vac once and she said it wasn't necessary; this was a suggestion by the sub.

Appreciate the info.... just trying to picture it.
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

Blueheron
Veteran Member


Date Joined Feb 2010
Total Posts : 720
   Posted 6/10/2011 6:12 AM (GMT -6)   
My wound was a little bit of everything, as I had it for about four months. First it opened through the muscle layer and then the surgeon had to stitch it back up (otherwise I had a hole going right into my abdominal cavity. Not good). That one looked like it was closing but then opened up again a tiny bit (just through the superficial layers that time). I packed that with gauze strips for about a month. Then it started to tunnel and my surgeon decided to surgically open it up again to see what was up since it should have been healing (I had been off of Prednisone for a while then). That is when he found it was due to a reaction to the dissolvable sutures in my muscle wall that I have mentioned in other posts. At that point, he couldn't stitch it up again (fortunately this was just the layers above the muscle again) and I got the wound vac for 6 weeks. The last bit of packing with Silver Alginate at the very end was just because at that point, my wound was too small to put the wound vac sponge on anymore, and it just needed that tiny bit of packing to finish up the job. I remember when I first got the wound vac they said I would need it for two weeks, which eventually turned to six. You just never know what to expect with wound healing, but I think it would be good to try if you get the chance. It keeps the wound clean and increases blood flow to the area. I know two folks who had them for their butt wounds, and they worked very well.
-39 years old
-Officially diagnosed with UC in 2006, though had symptoms since 1999.
-Had mild/moderate symptoms continuously until severe flare in autumn 2010 which required 2-week hospital stay
-Took Asacol, Rowasa, Canasa and Prednisone to manage flares but meds stopped working
-Tried 1 dose of Remicade but had excruciating joint pain and discontinued
-Had permanent ileostomy surgery 11/8/2010

Brian84
Regular Member


Date Joined Mar 2005
Total Posts : 456
   Posted 6/10/2011 5:04 PM (GMT -6)   
I had mine for almost 3 months. It works well for most people but unfortunately it didn't do anything for me :( I believe there are different types but mine pretty much looked like a womans purse, but with a vacuum line coming out of it. Heck, you can probably stick it in your purse if you have one large enough and nobody will notice. It makes a little bit of noise, but you will only hear it if it's really quiet in the room.
Also you don't have a ton of mobility with your legs because there has to be vacuum pressure and it it opens up even a hair, the machine will alarm.
I've heard of a wound healing product called Microcyn. Look it up, it has nothing but positive reviews. You do need a prescription though so I need to try and get one from my doctor. I'm hearing all thse people saying their wounds heal within weeks.

Brian84
Regular Member


Date Joined Mar 2005
Total Posts : 456
   Posted 6/10/2011 5:14 PM (GMT -6)   
Blueheron said...
I had a wound vac. Mine was on my abdominal incision which was hard to deal with because it was so close to my appliance that every time I had the wound vac dressing changed (about every other day), I also had to change my appliance. It was also extremely painful for me (especially the sponge dressing changes) which my surgeon and nurse said hardly ever happens. It just seemed to be aggravating some tender nerves. I was prescribed Lidocaine to put in the wound before dressing changes which helped a lot. I also took Vicodin. The plastic sheeting they used to tape the sponge down and keep the suction was very irritating to my skin because it doesn't breathe at all, but skin prep helped some. After I finally had the wound vac off, my skin irritation healed quickly. Leaks in the suction were annoying, but easy to fix.

Still, even with all these annoyances, I would do it again in a heartbeat. It was on my wound for six weeks and then I had Silver Alginate dressing for another week and everything healed up beautifully. I can't even imagine how long it would have taken just packing the wound.

I toted the wound vac around with me everywhere, though that might be harder with a butt wound. Not sure. I even wore it to my meditation class a few times which was funny because it sounded like a coffee percolator. The noise was so distracting that I ended up turning it off during the actual meditations after making sure it was okay with my nurse, but you can't leave it off more than a couple of hours or you have to get the dressing redone. I could still wear my clothes with it. The tube just stuck out of the top of my waistband. It basically looks like a purse and you can hide the hose (which is kind of gross because it is clear and shows the drainage) by folding it under the flap of the carrying case and then tucking some in your clothing too. I was able to shower with it on by taping saran wrap over the dressing and turning off the suction. Sleeping with it was a bit weird because you have a tube stuck to you... but the hose is pretty long so you have some leeway. One night my machine turned off in the middle of the night because I did not hear an alarm on it telling me it was running out of juice (I had forgotten to plug it in to recharge). I had no idea how long it had been off, so I had to call the nurse in the middle of the night to come and redo the dressing. Boy did I feel stupid. So yeah, it is a bit of a pain but I would highly, highly recommend it.
I had the same problem as you. The sponge would dry out and bond to the tissue in the wound. When I would pull it out, I had to pull it really hard and when it finally let loose I would gush blood for about 2 minutes straight and it was extremely painful. My skin would also react to the tape and I had constant rashes and it hurt when the nurse would pull the tape off.

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 6/12/2011 4:03 PM (GMT -6)   
Brian and Blueheron thanks for all the details, I get a much better picture. Brian, how are you doing? Is your wound getting any better? I know you've been through a lot with it.

I was pretty discouraged when I was going on a plane on Friday and my wound was hurting in a way that it hasn't in at least a month. I wish I knew what I did, if anything, for it to open up again. But it doesn't hurt as much today (Sun) so hopefully Friday's pain was from the exam the day before or something else not long lasting. For a while my momentum was all in the good direction, but we know it doesn't always work that way.....

I will ask about the Microcyn -- I hadn't heard of that before, so thanks. I wonder if the coumadin that I'm on is making the wound heal more slowly (I have been off the pred for a few months, but I was on it a lot the last few years).
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

windy city
Veteran Member


Date Joined Dec 2010
Total Posts : 607
   Posted 6/12/2011 10:56 PM (GMT -6)   
I had the wound vac in the hospital. Gosh did it hurt. And the ileostomy change everytime too, it just wasn't fun. When I came home, I was doing the wet/dry care. After a few days, the nurse brought me this calcium/alginate material (ex. Aquacel & Maxorb) and started to see my wound speedly heal. This product never stuck to my wound and never leaked as it absorbs and turns product into a gel like form. about 8 days after that, the vac came and I denied it. I was feeling better, this product was working, and with 2 active small kids, it would have been hard with the vac. My wound closed in 6 weeks. I changed the calcium/alginate material every day, can be changed every other day (will kind of smell of fish), put an all purpose gauze on top and used non latex tape (was allergic to all others...silk, paper).

Brian84
Regular Member


Date Joined Mar 2005
Total Posts : 456
   Posted 6/13/2011 12:59 PM (GMT -6)   
Blueglass- I'm doing ok. I THINK it is healing a little bit, but im not sure because the Dr. didn't measure it last month. I am pretty sure he was in a hurry because I am usually in the office for an hour or two and this time less than 15 minutes. I have an appointment on July 1st so hopefully they measure it. Let me know what your Dr says about the microcyn. I will ask my Dr but it seems that they don't believe in things that they haven't used before.

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 6/13/2011 1:22 PM (GMT -6)   
Brian, glad to hear you're doing OK. I have thought about you a lot, wondered how it was going.... I hate it when the doc is in a hurry, hope the next appt is better.

I emailed my nurse about microcyn. My surgeon said that nurses know more about wound healing than docs do, so I thought I'd start there. Haven't heard back yet, but it was only earlier today.

Windy city, I had the calcium alginate too.... but my wound just stayed the same for weeks, didn't heal.... When I switched to the sodium chloride dressing (mesalt) it started getting better. I hope that will help again.
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery

windy city
Veteran Member


Date Joined Dec 2010
Total Posts : 607
   Posted 6/13/2011 6:27 PM (GMT -6)   
I hope it will help again too. What Brian stated his true in my case as well, regarding the surgeons. He doesn't believe in the wound vac, probably doesn't get that much exposure to make a more valid opinion. When I came in the office after a month of being discharged, I brought my calcium alginate & other supplies with me. I performed a wound change before him. He was unfamiliar with the procedure and also with the product. He is only used to the wet/dry wound packing. From my experience too, nurses know more regarding all the latest wound care and what will work for your situation.

blueglass
Veteran Member


Date Joined Dec 2010
Total Posts : 3332
   Posted 6/13/2011 8:37 PM (GMT -6)   
One thing I really like about my surgeon is that she's willing to admit that the nurse knows more than she does, even says how much she's learned about wound care from the nurse....

You do want a surgeon to be confident, it would be awful to have them not be sure they could do a good job of your surgery.... but it's so easy for that to turn into thinking they know things they don't.....

I got the sense that calcium alginate is kind of wound care 101..... all the visiting nurses I had knew about it, and they weren't WOC nurses....
48 years old, female.
2004 dx indeterminate colitis. Back and forth between Crohn's and UC dx. Many drugs, minimal success.
2010-11 Crazy skin and eye complications, high fevers, bad flaring. Out of good drug options, tired of scary drugs.
Feb 2011 -- proctocolectomy with permanent ileolostomy; abscess, blood clot. Still healing, still glad for the surgery
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