Recovery Tips for Sacral Pressure Injuries After Surgery

Contusion issues

Hello Doctor, due to a previous severe injury and subsequent surgery, I experienced significant pain and was unable to care for myself, which led to a pressure sore on my coccyx.
During my hospitalization, the necrotic tissue was surgically removed, and now it is almost healed with about one centimeter of scab remaining.
I would like to ask if the skin indentation caused by the pressure sore will fill in over time, as there is a noticeable difference in texture between the skin on either side.
Because of this condition, I can only sleep on my side.
Do you have any recovery methods or recommendations? I have also attached a photo link with the password 0701: https://risu.io/20kLy.

Ili, 30~39 year old female. Ask Date: 2022/07/01

Dr. Lu Daokuan reply Plastic Surgery

Pressure ulcers occur due to prolonged pressure on the same position, leading to insufficient blood flow and tissue necrosis.
After debridement, there may be a significant loss of tissue.
Typically, as the wound heals, the indentation will gradually decrease, theoretically by about half.
If there is significant concern about the indentation, it may be necessary to evaluate other reconstructive options such as flap surgery or autologous fat grafting.
Once the wound is nearing healing, it can begin to bear pressure, ideally limited to 1 hour at a time.
After healing, this can be increased to 2 hours, and eventually to 4 hours (4 hours is considered normal).

Reply Date: 2022/07/01

More Info

Recovering from sacral pressure injuries, especially after surgery, can be a challenging process. It is essential to understand the nature of the injury and the steps needed for effective healing. Here are some recovery tips and insights based on your situation.

Understanding Sacral Pressure Injuries
Sacral pressure injuries, commonly known as bedsores or pressure ulcers, occur when there is prolonged pressure on the skin, leading to reduced blood flow and subsequent tissue damage. After surgical intervention, the risk of developing these injuries can increase due to immobility and the body's healing response. The fact that you have undergone surgery to remove necrotic tissue is a positive step towards recovery.

Healing Process
1. Skin Integrity: The area around the sacral pressure injury may appear different in texture and color compared to surrounding skin. It is not uncommon for the skin to be slightly indented or have a different feel. Over time, with proper care, the skin may regain some of its normal appearance, but complete restoration can vary based on individual healing processes.

2. Wound Care: Continue to keep the wound clean and dry. Follow your healthcare provider's instructions for wound care, which may include using specific dressings that promote healing and protect the area from further injury. Regularly changing the dressing and monitoring for signs of infection (increased redness, swelling, or discharge) is crucial.

3. Nutrition: Adequate nutrition plays a vital role in wound healing. Ensure you are consuming a balanced diet rich in proteins, vitamins (especially Vitamin C and Vitamin A), and minerals (like zinc) to support skin regeneration and overall recovery.

4. Pressure Relief: Since you mentioned that you can only sleep on your side, it is essential to use pressure-relieving devices. Consider using specialized mattresses or cushions designed to reduce pressure on the sacral area. Regularly changing your position, even when side sleeping, can help alleviate pressure on the wound.

5. Physical Activity: As much as possible, engage in gentle physical activity to improve circulation. If you are able, try to incorporate movements that do not put pressure on the sacral area. Consult with a physical therapist for tailored exercises that can promote healing without risking further injury.

6. Moisture Management: Keeping the area dry is essential, but it is also important to avoid excessive dryness, which can lead to cracking. Use appropriate moisturizers around the wound (not on the wound itself) to maintain skin elasticity.

7. Follow-Up Care: Regular follow-up appointments with your healthcare provider are crucial. They can assess the healing process and make necessary adjustments to your care plan. If you notice any changes in the wound or surrounding skin, report these to your provider immediately.

Addressing Concerns about Skin Indentation
Regarding your concern about the indentation of the skin, it is important to note that while some degree of skin remodeling can occur, it may not completely return to its original state. However, with time and proper care, the appearance may improve. Engaging in scar management techniques, such as silicone gel sheets or massage therapy (once the wound is fully healed), can also aid in reducing the appearance of scars and improving skin texture.

Conclusion
Recovery from sacral pressure injuries requires a multifaceted approach that includes proper wound care, nutrition, pressure relief, and regular monitoring. While the healing process can be slow, with diligent care and support, significant improvements can be made. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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