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Slow wound healing woes

ricke17 said:
Hello,

Thanks for reading this post.

I am Type 2 on a combination of insulin and oral medication.

Back in September 2017 I had emergency surgery to remove a burst sebaceous cyst on my back and it has since been very slow at healing. The wound was packed from the inside, so it would heal from the inside to the top. It seemed to heal towards the top only for pus to collect in the wound again needing draining. This week the wound had scarred over and both my GP and the practice nurse agreed it was healed. Then 48 hours later it had collected pus again and needed draining and now, frustratingly, I seem to be back to square one. Initially the wound was 2.5cm deep and now it's back to 2cm deep. The nurses seem to think that flooding this wound with medical honey will assist in healing, but they done this during the latter part of the healing process and clearly this did not work.

My question to the community is has others noticed very poor healing of wounds and do they eventually heal up?

My diabetes control is much better than it was but the wound just appears to not want to heal and I don't really want further surgery for removal/draining again! FYI I gave up smoking in September although I am vaping now with nicotine - perhaps this is not helping the wound heal?

I am super frustrated and fed up with this all now!

Rick.
Click to expand...

Are you seeing a tissue viability nurse?
 
It maybe time that you ask to see a tissue viability nurse, they have different options to offer than GP services...

I only know of the different options wonen have if their mastectomy wounds dont heal.. some have ended up with 10x5cm open, infected poisonous wounds...
I wont quite these options but it seems that you have the same similar type of wound problems.
They have to ask to see tissue viability nurses and then treatment does work..

I assume you've had the higest strength antibiotics?
 
Annoyingly I’m allergic to penicillin but am on the same ones they’ve been prescribing historically which, IMHO, doesn’t seem to do anything. They also swabbed it too. The last swab came back with a Staphylococcus infection and presumably it’s the same. It’s just super frustrating and getting me down. I will be asking for a referral to the TVN thanks for the advice.
 
About 18 months ago I had surgery to deal with breast fibromatosis. The condition was benign, but it still led to a fairly brutal op. Following that I developed a significant haematoma which decided to drain all by itself. Imagine something like a scene from CSI as I stood in the shower with blood cascading down my body. OK. Don't!

Bottom line is that was managed to heal from the depth of the wound, to the surface. I didn't have to have my wound packed, as it was filled with congealed blood, which used to free itself up in egg-sized clots. Nice. OK. Not nice, and probably TMI.

Anyway, such an open wound inevitably became mildly infected, despite very careful management and an HbA1c of 31, so I had a couple of courses of antibiotics along the way. I am actually what my surgery calls a super healer, in that I heal very quickly, irrespective of my diabetes diagnosis.

The bottom line is that once the wound really got healing, one of my delightful tasks was keeping it open, to ensure there was no potential for a sealed pocket forming. Under no circumstances was I allowed to let the edges join together, so in the shower every morning, I had to check it was open, and if (after several weeks) it wasn't, I had to part the skin. Ooooh. That was a joyous 2-3 months.

So, maybe your challenge is as much about keeping your wound open until it is just no more, as I had to. It doesn't create a fine, thin scar, but it's not on view! Clearly, that's much easier when the dratted wound is on the front, as opposed to on the back. My poor old OH used to have to help me with my dressings in the early days, because of the wound site, significant swelling, and that it was still draining. The poor soul would be trying hard to do it, without looking.

At it's height I was seeing the ANP every couple of days, but as things subsided the visits became less frequent, although I would have been seen any day I felt I had an issue.

It's not a pleasant healing process. I don't envy you going back around the loop again. In your shoes, I want someone pretty specialised to be involved, because you don't need more and more scar tissue building up.

Really good luck with it all.
 
That does sound like a pretty awful journey you’ve been through. I’ll see what’s what on Monday and insist on a referral to a tissue viability nurse as (presumably) they’ll be more up to date with evidenced based practice than the practice nurses. Thanks for sharing your story though. My wound is in a super awkward place, I can just about manage to pop a fresh dressing on it and living alone doesn’t help. But I got my mate swinging by tomorrow so I’ll get her to give it a short back and sides and see how it is.
 
ricke17 said:
That does sound like a pretty awful journey you’ve been through. I’ll see what’s what on Monday and insist on a referral to a tissue viability nurse as (presumably) they’ll be more up to date with evidenced based practice than the practice nurses. Thanks for sharing your story though. My wound is in a super awkward place, I can just about manage to pop a fresh dressing on it and living alone doesn’t help. But I got my mate swinging by tomorrow so I’ll get her to give it a short back and sides and see how it is.
Click to expand...

It wasn't great at the time, but people cope with so much worse, and thankfully it's history now.

I did say "Thanks but no thanks" to the offer of a bit of reconstruction. I didn't fancy any more messing around if it was avoidable. In the end, I wouldn't have had enough body fat for the procedure anyway, without spending some time trying to gain weight.

There are much worse things in this life than a bit of lopsidedness. :)
 
Immediately after I was diagnosed last year
Sept 2017 I went out for jogging almost everyday without realising I sustained a cut on my right ankle.

The cut was quite deep as I might have hit a curve.

Anyway it took about 5 weeks for the cut to heal only when my A1c dropped considerably.
 
I had a bad time last year with a wound/infection in a delicate place. It took weeks to heal. My nurse stressed that i was to leave the dressing in place between visits to her and to flannel wash, avoiding the area. She said the dressing was sterile and if I had moved it, the area would be subject to bacteria and it would delay healing.

It took 4 lots of antibiotics, a couple of months, and yes, lots of pus, but it did eventually heal. Not showering every day was hard, but it had to be avoided to keep the area sterile and dry.

All the best.
 
ricke17 said:
Hello,

Thanks for reading this post.

I am Type 2 on a combination of insulin and oral medication.

Back in September 2017 I had emergency surgery to remove a burst sebaceous cyst on my back and it has since been very slow at healing. The wound was packed from the inside, so it would heal from the inside to the top. It seemed to heal towards the top only for pus to collect in the wound again needing draining. This week the wound had scarred over and both my GP and the practice nurse agreed it was healed. Then 48 hours later it had collected pus again and needed draining and now, frustratingly, I seem to be back to square one. Initially the wound was 2.5cm deep and now it's back to 2cm deep. The nurses seem to think that flooding this wound with medical honey will assist in healing, but they done this during the latter part of the healing process and clearly this did not work.

My question to the community is has others noticed very poor healing of wounds and do they eventually heal up?

My diabetes control is much better than it was but the wound just appears to not want to heal and I don't really want further surgery for removal/draining again! FYI I gave up smoking in September although I am vaping now with nicotine - perhaps this is not helping the wound heal?

I am super frustrated and fed up with this all now!

Rick.
Click to expand...
Hi Rick.
Like you I have had surgery, in my case to drain a scrotal abscess. That was at end of last August. Had to have catheter fitted due to damage of the water pipe caused by the abscess. Wound seemed to take forever to heal and like yours had to heal inside out. Got an appointment to go back in November for camera check under general anaesthesia where it was discovered that another one had started to form resulting in original wound having to be extended. Wound still not healing properly and still in very severe pain. Have been told by consultant that it is very likely going to take a long time to heal. Hope everything turns out good for you. Regards.
Colin.
 
Hi Colin,

Ouchie. I do hope they’re swabbing any muck and giving you any antibiotics you may need. Mine has healed up but seems to have tracked to the left as pus is coming out of the hair follicles. Ultrasound for me on Wednesday and looks like I’ll have to have that drained under anaesthetic. Chin up mr.
 
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