Managing Wound Care for Inguinal Skin Issues: A Guide

Wound issues

Dear Dr.
Chen,
I apologize for bothering you.
My father has developed a small sore on his scrotum after squeezing a pimple (originally about 0.2 cm).
Initially, he did not cover it and only used ointment and tetracycline, which led to a worsening infection with yellow discharge and redness.
He was able to squeeze out pus at first, but yesterday, as the area began to form a thin layer of dead skin, he applied a burn ointment for debridement.
It seems that this was too irritating, resulting in additional small sores nearby.
1.
I am unsure how to proceed now.
Should we stop using the burn ointment and revert to just tetracycline? However, I am concerned that the dead skin might hinder the wound from healing properly.
I have heard that the new approach to wound care is to keep the wound moist to facilitate healing rather than letting it dry out.
Would it be best to use artificial skin to promote natural debridement? Isn’t debridement the most important step?
2.
Is it safe to use artificial skin on the genital area? When is the appropriate time to use it? I am quite troubled and unsure about the best course of action, especially since my elderly father is reluctant to go to the hospital for such a sensitive issue.
It seems to be getting worse.
3.
Which specialist should we consult? Urology or dermatology?
Thank you.

Xiao Xin, 30~39 year old female. Ask Date: 2017/08/17

Dr. Chen Jiaming reply Surgery

Wound care cannot be managed with a single guideline; each stage requires appropriate treatment methods.
It is recommended to consult a urologist or a general surgeon.
Some hospitals also have specialized outpatient clinics dedicated to wound care.
The skin of the scrotum is very thin, and if a sebaceous cyst becomes infected and is not promptly treated (with oral antibiotics and appropriate wound protection), it can lead to localized ischemic necrosis of the tissue due to the infection.
If necrotic tissue is visible, although some ointments claim to promote debridement, effective debridement of necrotic tissue typically requires actual surgical intervention for quicker and more effective results.
Otherwise, when necrotic tissue occupies that space, no matter how you change the dressings, healing will not occur (as the tissue cannot grow over to repair itself).

Reply Date: 2017/08/17

More Info

Managing skin issues, particularly in sensitive areas like the inguinal region, requires careful attention to both the type of wound and the treatment methods employed. Based on your description, it seems your father has developed a small wound on the scrotum after attempting to treat a pimple, which subsequently became infected. Here’s a comprehensive guide on how to manage this situation effectively.

1. Understanding the Wound
Initially, the wound was small, but it became infected due to improper care. The presence of yellow discharge and redness indicates an infection, which is common in such cases. The use of topical antibiotics like tetracycline is appropriate, but it’s crucial to ensure that the area is kept clean and dry to promote healing.

2. Treatment Options
Avoid Irritating Products: Since the burn ointment seems to have caused further irritation and additional small wounds, it’s advisable to discontinue its use. Instead, revert to using the tetracycline ointment, as it is specifically designed to combat bacterial infections.

Keep the Area Clean: Gently clean the area with mild soap and water. Avoid scrubbing, as this can exacerbate irritation. Pat the area dry with a clean towel.

Moisture Balance: It is essential to maintain a balance of moisture in the wound. While it’s true that wounds should not be allowed to dry out completely, they also should not be overly moist. A moist environment can promote healing, but excessive moisture can lead to maceration and further complications.

Consider Artificial Skin: Artificial skin products can be beneficial for wound healing, especially in sensitive areas. They can provide a protective barrier, promote moisture retention, and facilitate the natural healing process. However, it’s crucial to consult a healthcare professional before applying any artificial skin products to the genital area, as this region is particularly sensitive.

3. When to Seek Medical Attention
Given that your father is hesitant to visit a doctor, it’s important to emphasize the potential risks of not seeking professional help. If the wound shows signs of worsening infection (increased redness, swelling, or discharge), or if your father experiences pain or fever, he should see a healthcare provider immediately.
Specialist Consultation: For issues related to the genital area, both urologists and dermatologists can provide appropriate care. A urologist specializes in male reproductive health and urinary tract issues, while a dermatologist focuses on skin conditions. Depending on the severity of the infection and the wound, either specialist could be suitable.

4. Home Care Recommendations
- Avoid Tight Clothing: Encourage your father to wear loose-fitting underwear to reduce friction and irritation in the affected area.

- Monitor for Changes: Keep an eye on the wound for any changes in color, size, or discharge. Documenting these changes can be helpful if a doctor visit becomes necessary.

- Educate on Hygiene: Emphasize the importance of maintaining good hygiene practices, especially in sensitive areas, to prevent future infections.

Conclusion
Managing wounds in sensitive areas like the inguinal region requires a careful approach to treatment and hygiene. While topical antibiotics can be effective, it’s essential to avoid irritating products and maintain a balanced moisture level in the wound. If the situation does not improve or worsens, seeking medical attention is crucial to prevent complications. Encourage your father to prioritize his health and consider consulting a specialist for the best outcome.

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