Tissue viability

The Tissue Viability Clinic that I mentioned in my last post is an offshoot of the hospital Plastic Surgery department, and is basically staffed by the specialists in treating awkward to heal wounds. They understand all the different techniques that can be brought to bear including things like specialist dressings, negative pressure wound therapy, etc. In my case, the main reason for consulting them was the possible advantages that might be available from the negative pressure wound therapy (NPWT), and whether I would be a candidate for such treatment or not.

My first meeting was really helpful, but there was a lot of doubt about NPWT being useful in my case. Fundamentally, the issue is the location and shape of my perineal wound, the difficulty of creating a good enough vacuum dressing, and how intrusive on the rest of my recovery this would be.

NPWT seems to be easiest to use on relatively large but shallow wounds, whereas I have a small but extremely deep wound, that could potentially provide access to internal organs such as my small intestine and bladder. So positioning the foam wound bed would be extremely difficult, and potentially harmful if done incorrectly.

Sealing the wound to allow the vacuum to form would require a dressing in the perineal region, high up between my buttocks. The difficulty in achieving this would be high, as would be the likelihood of my breaking that seal if I moved around very much. Once the seal was damaged the dressing could then draw infection into the wound from the outside, which would be worse than not having it at all.

Taken together, the feeling was that these were all contra-indications for giving me NPWT, especially now that I am “out in the community”. If I were full-time hospitalised they might attempt it … but not now that I am at my current stage of recovery – it would be too many backward steps.

Which means that for now, I just have to continue as I am.

In other news, I seem to have caught a really irritating dry cough, which I can’t seem to suppress with my normal topical solution (Pholcodine Linctus, which barely touches it). Sadly, as this has continued, it’s been getting increasingly painful to cough – apparently as I cough I’m pulling at some of the rows of internal stitches, something that I’ll be susceptible to for up to three months after my surgery. Hopefully it will all start to go away in the next few weeks, but in the meantime, Ibuprofen seems to help a lot with the pain.

I’m also still struggling with a lot of pain in my left kidney, even after my stent has been removed. I’ve been back in touch with my urologist, so now I’m just waiting to hear back from him. Hopefully this at least is something minor and easily resolved like a urinary infection, but time will tell, I guess.

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