Practical Issues in Wound, Skin and Ostomy Management
I have a primary M.D. and going to be evaluated by wound care doc. I have a small wound (appx. 1/2″ or so long and 1/8/ to 1/4″ wide. It is over my shin where I had a fracture at age 15 (54 now) it was compound so I have scar where my skin was torn. I rec’d septra (allergic to amoxicilin) x 10 days without infection initially. Now after two months due to poor capillary circ from scarring, it is very slow to heal. My primary did a culture yesterday and prelimary reveals “rare PMN’s” awaiting 3 day period. My concern is although I am going to go to a “wound center” soon, I’m from a relatively small town. Secondly, this wound is very close to the tibia due to old compound fx and I also had “chronic” versus acute osteomyelitis (stemming from that fx). This was treated 2 years ago with antibotics and hyperbaric o2. CT scan revealing NO Evidence of Osteo after 1 mo of HBO. I’m generally very careful with my leg, but have had 3-4 skin tears in the past with the last (before this time) tear being prior to finding out I had chronic osteo. Are there any specific questions I should ask wound doctor? Please advise as Im concerned. Thank you.
It is very important that the new wound doctor is familiar with the history of your wound and previous treatments to help with new treatment plans. It could be possible that the osteo is still present but not showing on a traditional x-ray. MRI tests can be used to double check traditional x-rays. http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/PDF_Library/2012%20Diabetic%20Foot%20Infections%20Guideline.pdf
In addition, underlying circulatory status should be checked if not already completed. Here is link to article that discusses various underlying causes of leg ulcers, not to scare you with these, but it is always important to make sure everything has been ruled out when you have a re-occurring wound. https://www.health.wa.gov.au/WoundsWest/docs/WPR_Nov09_Atypical_Leg_Ulcers.pdf
Hope some of these ideas help you out.
Wishing you good healing!
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