Wound care: Wound has healed, but skin around breaking down

Posted by charlena @charlena, Dec 27, 2021

My husband incurred a wound on his lower right leg. The wound iteself has healed. The problem is the skin around the wound is breaking down. He is using Silvercel antimicrobial alginate dressing on the area. He is experiencing very bad stinging, burning and some bleeding in this area. So bad he cannot sleep at night. Has anyone had experience with this type of skin breakdown? If so, please advise if you know of anything that can be used to help with the pain. Thank you.

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Hi, Charlena, if this were my husband I’d be encouraging him to seek medical attention for this wound as quickly as possible and stop using the Silvercell Alginate dressing. A wound that ‘heals’ but then has tissue breaking down around, especially with those symptoms, has not healed.
He could have a secondary bacterial infection going on or an allergy to the dressing, Better to be safe than sorry.

Did your husband see a doctor after the original wound?

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@loribmt

Hi, Charlena, if this were my husband I’d be encouraging him to seek medical attention for this wound as quickly as possible and stop using the Silvercell Alginate dressing. A wound that ‘heals’ but then has tissue breaking down around, especially with those symptoms, has not healed.
He could have a secondary bacterial infection going on or an allergy to the dressing, Better to be safe than sorry.

Did your husband see a doctor after the original wound?

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Yes, he is being treated at the Emory wound center. All of his doctors are with Emory and he has outstanding success with them (they have saved his life several times). But, the wound center is a HUGE disapointment. He initially used coloplast (I think this is correct, I'm not at home and can't look to see) and was changed to a purple dressing and now to the silver algniate. He may, indeed, be allergic to the silver alginate! He tried medihoney but that really burned. (The wound had been treated early on w/the medihoney while he was in the hospital.) Thank you for your response!

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@charlena

Yes, he is being treated at the Emory wound center. All of his doctors are with Emory and he has outstanding success with them (they have saved his life several times). But, the wound center is a HUGE disapointment. He initially used coloplast (I think this is correct, I'm not at home and can't look to see) and was changed to a purple dressing and now to the silver algniate. He may, indeed, be allergic to the silver alginate! He tried medihoney but that really burned. (The wound had been treated early on w/the medihoney while he was in the hospital.) Thank you for your response!

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Wow, I’m really sorry your husband’s having such a rough go of this! And I’m sure it’s really discouraging not to get his usual comprehensive care from the clinic. How long ago was he injured?

Does he have any of the following symptoms?
Drainage from the wound such as pus
Redness or warmth around the wound, particularly if it’s spreading
Bad odor
Increasing pain
Darkening skin at the edges
Fever

You mentioned different wound care treatments that he’s tried. Has he reported to the Wound clinic that there is still some peripheral tissue damage happening? Were they the ones recommending the change in dressing? In my opinion, they may need to get more aggressive if this has been going on for some time.
Does your husband have any underlying conditions such a diabetes which could be slowing his healing?

REPLY
@charlena

Yes, he is being treated at the Emory wound center. All of his doctors are with Emory and he has outstanding success with them (they have saved his life several times). But, the wound center is a HUGE disapointment. He initially used coloplast (I think this is correct, I'm not at home and can't look to see) and was changed to a purple dressing and now to the silver algniate. He may, indeed, be allergic to the silver alginate! He tried medihoney but that really burned. (The wound had been treated early on w/the medihoney while he was in the hospital.) Thank you for your response!

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@charlena Good morning. I must agree with @loribmt , your husband must see a doctor today. If the wound center has a doctor, go there, unless you didn’t like the doctor at the wound center. Or his primary care doc, or the emergency room, or urgent care. A “simple” wound can become dangerous quickly
Will you let me or Lori know what you learn?

REPLY
@loribmt

Wow, I’m really sorry your husband’s having such a rough go of this! And I’m sure it’s really discouraging not to get his usual comprehensive care from the clinic. How long ago was he injured?

Does he have any of the following symptoms?
Drainage from the wound such as pus
Redness or warmth around the wound, particularly if it’s spreading
Bad odor
Increasing pain
Darkening skin at the edges
Fever

You mentioned different wound care treatments that he’s tried. Has he reported to the Wound clinic that there is still some peripheral tissue damage happening? Were they the ones recommending the change in dressing? In my opinion, they may need to get more aggressive if this has been going on for some time.
Does your husband have any underlying conditions such a diabetes which could be slowing his healing?

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Thank you for your comment. He doesn't have diabetes. But he does take Prednisone for PMR. I think he may have become allergic to the Vasche wound wash. When he changes the dressing and uses the Vasche wash the leg starts stinging and burning at a 10+ on a scale of 1-10. His dermatologist suggested using Dove to wash the wound.

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@becsbuddy

@charlena Good morning. I must agree with @loribmt , your husband must see a doctor today. If the wound center has a doctor, go there, unless you didn’t like the doctor at the wound center. Or his primary care doc, or the emergency room, or urgent care. A “simple” wound can become dangerous quickly
Will you let me or Lori know what you learn?

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His leg actually looked a bit better a couple days ago. But last night when he changed the dressing and used the Vasche wound wash the leg starting stinging and burning at a 10+ level. His dermatologist suggested he use Dove to wash the leg. I'm wondering if he has become allergic to the Vasche wash.

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@charlena

His leg actually looked a bit better a couple days ago. But last night when he changed the dressing and used the Vasche wound wash the leg starting stinging and burning at a 10+ level. His dermatologist suggested he use Dove to wash the leg. I'm wondering if he has become allergic to the Vasche wash.

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Wow, I wonder too. Especially since he’s been recovering and then out of the blue he’s having that severe stinging and burning! Sends up a red flag, doesn’t it? Since his leg is looking so much better, plain soap and water might be all that is needed for cleansing, since it’s bandaged anyway.

So yes, I’d follow the dermatologist suggestion of a really mild soap.
Examples are Dove Sensitive Skin Bar,
(I had to use Basis Sensitive Skin Bar in the hospital)
Oil of Olay facial cleanser, Cetaphil Cleanser and Aveenobar are all very gentle.

The poor guy, and you too, must be getting so frustrated over how long this is taking. I’m sure you can’t wait until life gets back to normal and isn’t focused on his leg! Is he able to work and get around ok?

REPLY
@loribmt

Wow, I wonder too. Especially since he’s been recovering and then out of the blue he’s having that severe stinging and burning! Sends up a red flag, doesn’t it? Since his leg is looking so much better, plain soap and water might be all that is needed for cleansing, since it’s bandaged anyway.

So yes, I’d follow the dermatologist suggestion of a really mild soap.
Examples are Dove Sensitive Skin Bar,
(I had to use Basis Sensitive Skin Bar in the hospital)
Oil of Olay facial cleanser, Cetaphil Cleanser and Aveenobar are all very gentle.

The poor guy, and you too, must be getting so frustrated over how long this is taking. I’m sure you can’t wait until life gets back to normal and isn’t focused on his leg! Is he able to work and get around ok?

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He had to retire due to being elected off a tugger at work and breaking his hip last January. That was another nightmare. He was raken to a lical hospital where he was kept outside the ER on a gurney for 31 hours without food or water or pain meds I was finally able to get him transported to Emory which was a 3 hout drive without any pain meds. He had hip surgery developed a DVT which went to his lung and was in ICU for 2 weeks. He can get around but not very well at all.

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@charlena

He had to retire due to being elected off a tugger at work and breaking his hip last January. That was another nightmare. He was raken to a lical hospital where he was kept outside the ER on a gurney for 31 hours without food or water or pain meds I was finally able to get him transported to Emory which was a 3 hout drive without any pain meds. He had hip surgery developed a DVT which went to his lung and was in ICU for 2 weeks. He can get around but not very well at all.

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Oh my goodness! I can’t even imagine the pain he must have been in! I’m so sorry you both had to endure this nightmare. His life changed abruptly with a forced retirement the hardest way! It must be very difficult for him to adapt to that abrupt end to his career, then having to recover from his hip surgery and now his wound is another setback.

Does he have any physical therapy exercises to help him get more mobile?

Retirement should be an enjoyable time of life. So you’re both in my thoughts and hopes for a better year ahead.

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He did have some out patient PT. He does try to do some at home as well.

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@charlena

He did have some out patient PT. He does try to do some at home as well.

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That’s great! Encourage him to keep up the good work!
If you can motivate him to become more active such as taking walks daily, maybe a couple short walks, he’ll be amazed at how much better he’ll feel. The increased circulation from the exercise will help his entire body. His wound will heal faster, his new hip will flex better and overall he’ll have less muscle soreness and stiffness and his outlook will improve.

Is he feeling a little depressed with all the changes of this past year?

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