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Health professionals and those with experience in wound care


Jean in Newcastle
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I have a hole in my leg.  It's been there for over a year.  It will heal - sort of - and then will get worse again - not quite to the point of being an ulcer and then repeat the process.  Right now it has gotten worse again.  Two doctors looked at it and said "it beats me" and told me to go to a dermatologist.  I went to the dermatologist who looked at it and said "it beats me" but took a biopsy.  The pathologist says that I have stasis dermatitis with continual edema (which I do wear compression stockings for) and "skin that is bad".  It is  not infected so there is no medical treatment offered.  They did say that they could cut out the bad skin and pull over good skin but I'm afraid with my entire leg being rather iffy, would be hard to do and that I would be right back in the same boat regarding things not healing.  So. . . the place where they biopsied is black with dark red discoloring around it and is not healing (surprise, surprise).  Is there any kind of special dressing I can put on it?  I'm putting a tea tree oil/ vitamin D oil on my legs but it is doing nothing.  My fear is that with my poor immune system that at some point in time this could actually become infected and then things could get really bad.  So I'd like to be proactive in trying to promote healing and circulation.  Any suggestions? 

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At the wound clinic we visited with my dd, they used dressings impregnated with Manuka honey and others impregnated with silver (silverlon). We used Mepilex AG and regular Mepilex and sometimes we used Tegaderm cut in strips to adhere other dressings or used a base of Duoderm and taped to that.

 

Is your skin fragile or just poor circulation? Have they cultured it recently?

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After my surgery last year, my foot got infected and then the wound stopped healing.  It is like the body had given up on closing the wound.  They ended up sending me to a wound clinic where many elderly people and diabetics go for treatment of stubborn wounds.  At first, we did a protocol of Manuka honey (which has antibacterial properties) combined with debridement to kickstart the healing process.  Then, they did put some collagen product on the wound to help healing and tissue growth.  It took about 4 weeks.  I also had to wear pressure stockings to keep the swelling down due to poor circulation caused by my mobility issues.  I would see about getting into a wound clinic.  They seem to know so much more about how to get the body to fix itself than regular dermatologist and surgeons.  

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At the wound clinic we visited with my dd, they used dressings impregnated with Manuka honey and others impregnated with silver (silverlon). We used Mepilex AG and regular Mepilex and sometimes we used Tegaderm cut in strips to adhere other dressings or used a base of Duoderm and taped to that.

 

Is your skin fragile or just poor circulation? Have they cultured it recently?

 

They cultured it when they did the biopsy - about a month ago.  No fungus, no bacteria, no cancer, no autoimmune blisters (which they tested for because initially it was blistered).  They didn't seem to know exactly why it is this way - I probably do have poor circulation and I have constant inflammation - at times my whole body is the Stay-Puft-Marshmallow Woman -not just my legs but my legs seem to be more constantly affected. 

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why? 

Anything that is put on healthy tissue that keeps it moist can cause it to be macerated and just create a larger wound. 

 

They cultured it when they did the biopsy - about a month ago.  No fungus, no bacteria, no cancer, no autoimmune blisters (which they tested for because initially it was blistered).  They didn't seem to know exactly why it is this way - I probably do have poor circulation and I have constant inflammation - at times my whole body is the Stay-Puft-Marshmallow Woman -not just my legs but my legs seem to be more constantly affected. 

Poor circulation can make it difficult for wounds to heal.  Most of the people in the wound clinic were wearing slightly compressive sleeves on their limbs with wounds.  It sounds like you may need more care than you can find over the counter.  I would see if you can get into a wound clinic.  They have access to equipment and materials that can help jumpstart wound healing when it has stalled. 

https://www.advancedtissue.com/benefits-compression-therapy/

 

I had the beige tubular dressings for my wound care. 

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More exercise to improve circulation.  Work up to walking an hour a day, plus lift weights or do some resistance exercise, it radically changes hormones for the better.

 

Besides honey, the other thing wound care centers use is vinegar.  But that tends to be more for open, deep wounds they can pack with dressings that are soaked in vinegar.

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When DH worked in the burn unit, the go to was colloidal silver ointment.  

 

I second going to an actual wound care clinic.  If you're unaware of one, try calling an endocrinologist's office for a reco.  Diabetics often have wound healing issues, and they would likely know of a good one.

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A wound care clinic one of my relatives has gone to used maggots under a sterile dressing to clean up dead tissue and speed healing.  It worked on a leg wound that wasn't healing for 1-2 years.  Do you have a teaching hospital with a wound clinic near you that might do this?

 

https://www.scientificamerican.com/article/news-science-shows-how-maggots-heal-wounds/

 

 

Edited by reefgazer
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Not an MD...I am somewhat reluctant to suggest anything but I would perhaps try Silver Shield or Silver Cream. It is supposed to help with healing. If it does not help, I am hoping it could not hurt.

 

Something like this but there are several brands: http://www.professionalsupplementcenter.com/ACS-200-Silver-Gel-Extra-Strength-by-Results-RNA.htm?referrer=googleshopping&gclid=CKKPytC-tNMCFQmqaQodSH4JnA

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A wound care clinic one of my relatives has gone to used maggots under a sterile dressing to clean up dead tissue and speed healing.  It worked on a leg wound that wasn't healing for 1-2 years.  Do you have a teaching hospital with a wound clinic near you that might do this?

 

https://www.scientificamerican.com/article/news-science-shows-how-maggots-heal-wounds/

 

:ohmy: :w00t:

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I am new to the boards but saw your question and wanted to reply.  I have a friend who had a hole in her ankle that would not heal...went to several doctors in Eugene/springfield Oregon and finally saw one that took a look at it and said he could have it healed in 3 weeks.  My friend laughed out loud!  But he said her problem was varicose veins that were keeping the blood and oxygen from getting to the wound.  He stripped her veins in her leg and it was healed in 3 weeks...not saying this is your problem but might be something to look into.  

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Does it have a depth? Is it just superficial or does inttunnel down?

Right now it seems superficial with basically a black scab. It's been deeper in the past. I think that the dermatologist said that she thought that the biopsy (which included cauterizing the wound because it wouldn't stop bleeding) might promote some more healing. So far that hasn't been the case but it's only been a month.

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