Slow wound healing after cellulitis?
Hello Doctor: Two months ago, I had a car accident that resulted in a wound about the size of a 50 NT dollar coin on the outer side of my left ankle.
After debridement, I went home, but it has been swollen since then.
Later, I went to a large hospital for examination and was diagnosed with cellulitis.
I was hospitalized for a week for treatment, and after discharge, I changed the dressing myself.
However, the wound is healing very slowly.
In the past two days, I noticed small blisters appearing near the wound, and this morning when I changed the dressing, I found that the blisters had all burst.
There is no significant itching, but there is a slight stinging sensation when applying medication, and there is continuous drainage of serous fluid.
Currently, I change the dressing twice a day and apply Fuskin cream, an antibiotic ointment.
Will these blisters spread? The wound is still oozing some blood; can I apply a hydrocolloid dressing to absorb the exudate?
Niming, 20~29 year old female. Ask Date: 2016/05/08
Dr. Li Zhonghuai reply Surgery
Hello! It may require an on-site examination to determine the situation.
From an internal medicine perspective, the recommendation is to administer antibiotics, while from a surgical perspective, debridement is necessary.
If there is pus, it must be incised and drained.
Avoid contact with tap water, and do not use artificial skin when the condition is unclear.
Stay safe! Changhua Hospital cares about you!
Reply Date: 2016/05/08
More Info
Hello, thank you for reaching out with your concerns regarding your slow wound healing after experiencing cellulitis. It sounds like you have been through quite a challenging time since your accident, and I appreciate your detailed description of your symptoms and treatment so far.
Firstly, slow wound healing after cellulitis can be attributed to several factors. In your case, the initial injury and subsequent infection likely disrupted the normal healing process. Cellulitis, which is a bacterial skin infection, can lead to inflammation and damage to the surrounding tissues, making it harder for wounds to heal properly. Additionally, factors such as poor circulation, underlying health conditions (like diabetes), nutritional deficiencies, and even the type of wound care being administered can significantly impact healing time.
The presence of blisters, as you described, can be a sign of tissue fluid accumulation, which is often a result of inflammation. While these blisters can be uncomfortable, they are not uncommon in the healing process. However, if they burst, it is essential to keep the area clean to prevent further infection. The fact that you are experiencing some drainage is also typical, especially in the early stages of healing, but it should gradually decrease over time.
Regarding your question about the potential for the blisters to spread, it is crucial to monitor the area closely. If the blisters are due to friction or irritation from dressings or movement, they may continue to appear. However, if you notice increased redness, swelling, or pus, it could indicate a worsening infection, and you should seek medical attention promptly.
As for your current treatment with Fuskin cream, it is an antibiotic ointment that can help prevent infection. However, if you are still experiencing significant drainage and slow healing, it may be worth discussing with your healthcare provider whether a different treatment approach is necessary. In some cases, a more potent systemic antibiotic may be required if there is an underlying infection that is not responding to topical treatments.
Using artificial skin or hydrocolloid dressings can be beneficial for managing exudate and protecting the wound. These dressings can help absorb excess fluid while providing a moist environment that promotes healing. However, it is essential to ensure that the wound is not infected before applying such dressings. If you decide to use artificial skin, make sure to follow the instructions carefully and monitor the wound for any signs of infection.
In terms of dietary considerations, a balanced diet rich in vitamins and minerals, particularly protein, vitamin C, and zinc, can support wound healing. Staying hydrated and avoiding smoking can also contribute positively to your recovery.
Lastly, if your wound continues to show signs of slow healing or if you have concerns about infection, it is crucial to follow up with your healthcare provider. They may recommend further evaluation, such as imaging studies or a referral to a specialist in wound care or infectious diseases, to ensure that you receive the appropriate treatment.
In summary, while slow wound healing after cellulitis can be frustrating, it is essential to remain vigilant and proactive in your care. Monitor your symptoms closely, maintain good wound hygiene, and consult with your healthcare provider for tailored advice and treatment options. Wishing you a smooth and speedy recovery!
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