We continued to treat the wound as the surgeon directed even though at this point my nurse had absolutely no belief that the surgeon was going to be the one that actually would heal the wound. At this point I no longer trusted the surgeon even a little bit. After nearly two years this wound was still basically the same size it was when I began seeing her. I was upset about the situation but was emotionally too "stuck" to do a whole lot to help myself.
The wound care surgeon finally decided to take me off of the Prisma and switch me to a Calcium Alginate dressing that had Silver in it. The dressing is supposed to absorb the drainage from the wound and as that happens the dressing will form a gel which is supposed to keep the wound moist for optimal healing. The silver that is in the dressing is supposed to help protect the wound from a very wide variety of bacteria to hopefully prevent an infection.
None of these things that the surgeon was recommending were helping me so the visiting nurse said that she had a contact with a nurse that specialized in wound care and she would like to bring her to see me to see if she had any suggestions as far as what would close this wound. This was when I decided to do something that would potentially help myself and agreed that the wound nurse could come to the following visit with my regular nurse.
When the wound specialist came to my house with my regular visiting nurse she wanted some background information on what we thought caused this wound in the first place and also what we had tried to use to get it to heal on its own. We answered all of her questions and then she got down to the business of looking at the wound. When she saw the wound she almost immediately knew what the problem was. My wound had developed very thick rolled edges on all the sides.
The wound care nurse explained to me that what had happened was that the epithelial cells had migrated down around the wound edges, the edges were healed so my body thought that the wound itself was also healed. It was explained to me that the only way that the wound would heal is if we got rid of those edges so that the epithelialization of the wound surface could occur. She suggested that we begin using silver nitrate on the wound edges. She told me that basically it would "melt" away the edges of the wound to convince my body that it needed to continue to work to heal the wound. While none of this sounded like it was going to be any fun, I agreed that it made logical sense and I was willing to give it a shot.
My visiting nurse went ahead and called the surgeon to run the idea by her and to get the order so that we could get the supplies. While the surgeon did not seem to think that it was a necessary step she did not object to us giving it a try. The supplies were ordered and a few days later my nurse applied the silver nitrate to the wound edges. When she first put it on it stung for a minute, but it did not feel nearly as terrible as I was warned that it would feel so we went ahead with it for a few more of the nursing visits. When I went back to the surgeon for a follow-up appointment she saw the edges of the wound and flipped out because they "looked awful". I explained to her what we were doing and our thinking behind it. Although she had originally okay'd this treatment once she saw what it was doing she insisted that we stop it and got upset that we had started it "without her orders to do so". Being that the surgeon was so incredibly displeased, we stopped using the silver nitrate, even though my nurse and I believed that it was an ugly yet necessary step toward the ultimate healing of the wound.
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