Although it may take some time, most stage I and stage II sores will heal with conservative measures. But stage III and stage IV wounds, which are less likely to resolve on their own, may require surgery. It sounds like you may have the stage that requires specialized care and surgical intervention. To find list of specialized surgeons, see www.acvim.org
The first step in treating a sore at any stage is relieving the pressure that caused it. You can reduce pressure by:
Changing positions often. Carefully follow your schedule for turning and repositioning — approximately every two hours. If you're unable to change his position on your own, a family member must be able to help. Using sheepskin or other padding over the wound can help prevent friction when you move.
Using support surfaces. These are special cushions, pads, mattresses and beds that relieve pressure on an existing sore and help protect vulnerable areas from further breakdown. These types of pads are found in human medical supply stores. They can really help.
The most effective support depends on many factors, including the level of your dog's mobility and the severity of your wound. . In general, protective padding such as sheepskin isn't thick enough to reduce pressure, but it's helpful for separating parts of the body and preventing friction damage.
Many dogs do well on specialized water beds. Here is an example:http://www.amazon.com/Cool-Bed-III-Cushioning-Waterbed/dp/B000Q7AHKK
Other nonsurgical treatments of pressure sores include:
Cleaning. It's essential to keep wounds clean to prevent infection. A stage I wound can be gently washed with water and mild soap, but open sores should be cleaned with a saltwater (saline) solution each time the dressing is changed. Saline solution is available at the drugstore, or you can make it at home by boiling 1 teaspoon of salt in 1 quart of water for five minutes. Store the solution in a sterile container and cool before using. Avoid antiseptics such as hydrogen peroxide and iodine, which can damage sensitive tissue and delay healing.
Removal of damaged tissue (debridement). To heal properly, wounds need to be free of damaged, dead or infected tissue. This can be accomplished in several ways — the best approach depends on your overall condition, the type of wound and your treatment goals. Again, you will need the veterinarian for this.
One approach is surgical debridement, a procedure that involves using a scalpel or other instrument to remove dead tissue. Surgical debridement is quick and effective, but it can be painful. For that reason, your vet may use one or more nonsurgical approaches. These include removing devitalized tissue with a high-pressure irrigation device (mechanical debridement), allowing your body's own enzymes to break down dead tissue (autolytic debridement), or applying topical debriding enzymes (enzymatic debridement).
Dressings. A variety of dressings are used to help protect wounds and speed healing — the type usually depends on the stage and severity of the wound. The basic approach, however, is to keep the wound moist and the skin surrounding it dry. Stage I sores may not need any covering, but stage II lesions are usually treated with hydrocolloids, or transparent semipermeable dressings that retain moisture and encourage skin cell growth. Other types of dressings may be more beneficial for weeping wounds or those with surface debris. Contaminated sores may also be treated with a topical antibiotic cream.
Hydrotherapy. Whirlpool baths (if possible...some vet clinics have these) can aid healing by keeping skin clean and naturally removing dead or contaminated tissue.
Healthy diet. Eating a nutritionally rich diet with adequate calories and protein and a full range of vitamins and minerals — especially vitamin C and zinc — has been shown to improve wound healing. Being well nourished also protects the integrity of the skin and guards against breakdown.For a Shepard 1000mg of Vit C per day and Zinc (at least 10-20 mg/day) would be a good start.
Muscle spasm relief. This is essential for both preventing and treating pressure sores. To help alleviate spasticity, your vet may recommend skeletal muscle relaxants that block nerve reflexes in your spine or in the muscle cells themselves. These drugs are helpful in reducing discomfort associated with the sores and help to promote healing by promoting relaxation.
I hope this gives you new ideas of how to help.