The wounds – don’t look if you’re squeamish

If you are squeamish please don’t click the read more as this post charts the course of Sarah’s injuries since the accident. Gory and pretty gross but we’re finding it a little less scary to keep a chart of progress (even though we seem to be going backs wards at the moment. It’s still a case of feeling that we’re doing more than simply observing.

These images cover the period from November 24th 2012 through to March 1st 2013

bus

Sarah’s injury

The original injury - the doctors drew this

The original injury – the doctors drew this. I took this picture from her notes

They fixed it into this!Day three – They fixed it into this!

2012-11-28-15.02Day four

2012-12-12-14.s26Day 9 – the black stuff is necrotic tissue

2012-12-1z7-15.0z0 Day 15 – Necrotic tissue expanding

2012-12-17-15.0z0Day 24 – The doctors realised that the necrotic tissue was expanding and
needed to be surgically cleaned.

Original wound - four weeks after accident - Before wound vac therapy

Day 28 (Four weeks to the day) – The wound has been cleaned and
this is what the wound vacuum dressing has been applied to.

New Era – The Vacuum dressing

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The wound vacuum dressing has a mesh which is placed on the wound,
followed by a black sponge. This is then sealed to the skin with copious amounts of sticky plastic until it’s 100% airtight.

A suction cup is placed against the sponge and a machine is switched on which places a vacuum on the wound.

This works in a number of ways:

1. A much more sterile environment
2. The suction draws the wound closer to the surface so you don’t have such a deep hole
3. It draws in granulating cells which encourage wound healing
4 All the muck from the wound is sucked into a replaceable cannister which is detached when full and thrown away

(Cat watches muck move through the clear plastic pipe and is transfixed)

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Day 31 – Christmas Eve. Wound Vacuum has been fitted for four days.
Can’t see much evidence in this pic but the ‘hole’ is not quite so deep.

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Day 35 – 28Th Dec – Note to self. TRY TAKE PHOTO from the same angle!!
Can’t see any real difference between these photos.

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Day 39 – New Years Eve – Hospital
Doctors so pleased with progression they say the vacuum can stop in ten days time

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Day 42 – For the first time I can see through the camera what I can usually see only in real life
The wound is definitely getting narrower and shallower. Definite progress!

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Day 52 – I forgot to take photos the time before so it’s been ten days and my GOODNESS what a difference! The hospital want to skin grafts but it is healing so well I wish we didn’t have to. I know that they say a skin graft will help hugely and any open wound is not a good thing but even so – It looks amazing to me.

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After a three week wait she got the skin graft.
No bending the leg for a full week!

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The donor site.
Did not help that the district nurse gave her the wrong dressing which got stuck to the wound!

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Skin grafts have taken!! Now we wait for the scar tissue to form.
This will take twelve to eighteen months at least and almost certainly this will mean more surgery.

2013-02-04-s15.02march

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The bruise (haematoma) Day three

2012-11-27-s11.04Day three – while this wound is not open it has been caused by the impact
to the knee bending it sideways and caused internal bleeding

The initial bruise (haematoma)Day five – blisters. but it still looks ‘innocent’ and pretty unscary
Mr Shah warned me that this would become a ‘hole’. I never dreamt how bad it would become.

2012-12-12-14.2s6Day nine – the start of the hole.

2012-12-12-14.29Day fifteen – the hole! Hard to think that used to be a ‘bruise’.

 What the 'bruise' haematoma - looks like nowDay fifteen – This is the day Sarah GP Surgery said
she needed to come in herself to get the results of her swabs.
So I lost my temper and showed them this picture and asked if
they thought this wound made it easy to walk…

 2012-12-a13-17.12Day 19 – New dressings are applied. Manuka honey!
Above is the same area before honey dressing and below (three days later!
) Pretty remarkable

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Day 24 – The doctors looking at the necrotic tissue on the other side of her leg have decided to do
surgery again and will clean them both up. back in to hospital from four days. :(

2012-12-17-z15.00Day 24

Haematoma wound - four weeks after accident - Before wound vac therapyDay 28  (four weeks to the day after accident) – Before wound vac therapy. The wound has been cleaned and varies between .5cm and 2cm deep. The wound vac therapy is supposed to suck out the yellow gunk and
draw up healthy cells (granulating cells) to encourage the holes to ‘fill up’.

The Vacuum dressing

Day 31 – Vacuum dressing has been on for four days.
Things are looking much better.

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Day 34 – You can clearly see the ‘hole’ or ‘divot’ as the nurse called it
but it’s already looking shallower

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Day 39 – WOW. You can really really see how the wound is starting to heal.
‘Divot’ shallower and the wound is clearly becoming smaller.

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Day 42 – Forgot to take a photo of the inside knee! :(
Here’s a photo of Sarah instead, enduring the agonising process of
removing the sticky plastic. Dressing changes take between four and six hours.
Two hours to remove the tape and another hour and a half at least to reapply, another 30 minutes to seal the leaks.

The worst day was when the district nurses were so useless I had to redo both dressing.
That was a full seven hour procedure.

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Day 52 – Again it seems to be healing brilliantly but they are little concerned re infection on this side. Yesterday was Aldo’s birthday and we shopped for a gift for him and did some grocery shopping. By 9 she was asleep and has slept most of the day to day. I know she finds it totally exhausting and gets frustrated.

I know when she is feeling better because she picks fights with me and argues about everything. When she’s not doing so well it’s much more peaceful but it brings a whole bunch of other worries!

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(The difference three weeks can make! Image below is from day 32)

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Having kept us waiting for three weeks with two ‘get to the hospital
and wait then leave’ she eventually got her skin grafts

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