Persistent Inflammation After Car Accident: Is My Wound Healing Properly?

Twenty days after the car accident, the abrasion on the leg is still inflamed?

I had a car accident on June 5th.
After the emergency treatment that day, I went to Hospital 803 on June 6th.
The nurse gently cleaned the wound with a cotton swab to remove blood and exudate, and then the doctor applied the artificial skin shown in the picture.
Until June 10th, the wound showed no signs of inflammation.
However, during the treatment process, which involved changing the dressing every two days, the artificial skin was already saturated with exudate after about 18 hours, so by the time of my next appointment, the wound was in a saturated state.
On June 10th, the wound became inflamed as shown in the picture, and the doctor at Hospital 803 continued to use the artificial skin.
I noticed that the surrounding skin became white and wrinkled each time the dressing was changed, appearing as if it had been soaked in liquid and was not breathable.
By June 18th, the wound was still inflamed, and the treatment method at Hospital 803 remained the same: gently rubbing the wound and applying artificial skin.
I found it strange that the inflammation persisted, so on June 19th, I switched to a Chinese medicine clinic.
The doctor used a cotton swab soaked in saline to vigorously clean the wound, stating that the impact was significant and there was necrotic tissue that needed to be removed forcefully for new skin to grow.
In the end, they also applied artificial skin, and I was instructed to return for follow-ups once a week.
As of now, my wound has been inflamed for 20 days with no signs of improvement.
Is this normal? I am confused about what the correct treatment is.
Is it really okay to continue using artificial skin, or should I allow the wound to breathe and apply other ointments, changing the gauze daily for faster healing? Should I consider switching hospitals? Since the artificial skin has absorbed all the exudate, can I change the dressing myself? Or is this normal and I am overthinking it? I am worried that the wound may worsen and develop cellulitis...
I have not come into contact with any tap water; I have been wiping myself while bathing and trying to avoid walking, keeping my foot elevated.

Xiao You, 20~29 year old female. Ask Date: 2017/06/25

Dr. Li Zhonghuai reply Surgery

Hello! It is recommended to apply a thick layer of antibiotic ointment (neomycin) after taking pain medication each day.
Use a sterile cotton swab and saline solution to clean the area thoroughly.
Change the dressing at least twice a day.
If there is no improvement, surgical debridement may be necessary.
Changhua Hospital cares about you.

Reply Date: 2017/06/25

More Info

After a car accident, it is not uncommon to experience complications with wound healing, especially if the wound becomes inflamed or infected. Based on your description, it seems that your wound has been persistently inflamed for over 20 days, which is concerning and warrants further evaluation.

When a wound is healing, it typically goes through several stages: hemostasis, inflammation, proliferation, and remodeling. Inflammation is a normal part of the healing process, but it should gradually decrease over time. If inflammation persists or worsens, it may indicate an underlying issue such as infection, inadequate wound care, or even a foreign body in the wound.

The use of artificial skin (or hydrocolloid dressings) is common for managing wounds, as it can provide a moist environment that promotes healing. However, if the dressing becomes saturated with exudate (the fluid that leaks from wounds), it can lead to maceration of the surrounding skin, which may contribute to further complications. The fact that your wound has been consistently inflamed and that the surrounding skin appears white and wrinkled suggests that the dressing may not be allowing for adequate airflow and could be trapping moisture, which is not ideal for healing.

In your case, it may be beneficial to consider the following steps:
1. Consult a Specialist: If you haven't already, consider seeing a wound care specialist or a dermatologist who can provide a more thorough evaluation of your wound. They can assess for signs of infection, necrotic tissue, or other complications that may not have been addressed.

2. Wound Cleaning: Proper cleaning of the wound is crucial. It sounds like the doctor at the new facility used saline to clean the wound, which is a good practice. Regular cleaning can help remove dead tissue and promote healing.

3. Dressing Changes: If the artificial skin is not working well for your wound, you might need to switch to a different type of dressing that allows for better airflow and moisture control. Some wounds benefit from being left open to air, while others may require a moist environment. Discuss with your healthcare provider the best dressing option for your specific situation.

4. Signs of Infection: Keep an eye out for signs of infection, such as increased redness, swelling, warmth, pus, or a fever. If you notice any of these symptoms, seek medical attention promptly.

5. Avoid Self-Treatment: While it may be tempting to change the dressing yourself, it's important to follow the guidance of your healthcare provider. They can give you specific instructions based on the condition of your wound.

6. Rest and Elevation: Continue to rest and elevate your injured area as much as possible to reduce swelling and promote healing.

7. Follow-Up Care: Regular follow-up appointments are essential to monitor the healing process. If your wound does not show signs of improvement or if you have concerns about the treatment plan, do not hesitate to seek a second opinion.

In summary, persistent inflammation after a car accident can indicate complications that need to be addressed. It is crucial to work closely with healthcare professionals to ensure proper wound management and to prevent further issues such as cellulitis or other infections. Your health and recovery should be the top priority, so do not hesitate to advocate for yourself and seek the care you need.

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