Post-Accident Recovery: Managing Swelling and Wound Care

One month after the car accident?

Hello Doctor: Since the car accident on March 15, my injury has not healed (I have been using artificial skin) and I am still experiencing fluid drainage.
The wound is located above the prominent bone on my left ankle (there is a black spot in the wound, which is said to be charred).
The second doctor I consulted mentioned that there is a abrasion down to the periosteum, which makes healing more difficult.
After the injury, my foot started to swell and hurt, preventing me from putting weight on it (the inner and outer sides of the ankle, the dorsum of the foot, and the toes are all swollen), so I have been using crutches for about two weeks.
I need to walk frequently for work, which causes more swelling, but I elevate my foot with a triangular pillow while sleeping, which reduces the swelling a bit.
The condition has been fluctuating; currently, the swollen area on my foot does not rebound much when pressed, feels warmer than the other foot, and there seems to be a jelly-like substance under the skin.
Sometimes there is slight pain when pressed, and the color of the dorsum of my foot is much darker than the other foot.
The inner and outer sides of the ankle are still swollen, and recently, I have noticed a few small red spots on my calf.
The first hospital prescribed Lifu for me to change the dressing myself for the first eight days, but the wound did not improve.
On the 23rd, I switched to Kaishilifu, but there was still no improvement, so I consulted a second hospital for dressing changes.
Could you please explain the reasons for the persistent swelling and dark color? What signs should I watch for while caring for the wound? How can I improve the situation? Should I be concerned about venous thrombosis or cellulitis? Thank you.

Li Ya Lie, 20~29 year old female. Ask Date: 2018/04/14

Dr. Li Zhonghuai reply Surgery

Hello! If there is necrosis, debridement is necessary.
Do not use artificial skin yet, as it may damage the periosteum and risk developing osteomyelitis.
The effectiveness of Lifup is relatively poor, so consider switching to other ointments.
There will be some degree of pigmentation after the injury, which will take time to fade.
Take care! Changhua Hospital cares about you!

Reply Date: 2018/04/14

More Info

Post-accident recovery, especially after a car accident, can be a complex process that requires careful management of swelling, wound care, and overall rehabilitation. Based on your description, it seems that you are experiencing significant swelling and complications with your left ankle injury, which may include issues such as hematoma formation and potential infection. Here are some insights and recommendations for managing your recovery effectively.

Understanding Swelling and Its Causes
Swelling, or edema, is a common response to injury. It occurs due to the accumulation of fluid in the tissues, which can be exacerbated by inflammation. In your case, the swelling in your ankle and foot may be due to several factors:
1. Injury Severity: If the injury has affected the periosteum (the membrane covering the bones), it can lead to prolonged swelling and pain.

2. Hematoma Formation: The presence of a "black spot" in your wound may indicate a hematoma, which is a localized collection of blood outside of blood vessels. This can contribute to swelling and may require drainage if it does not resolve.

3. Infection: The fact that your wound is still oozing and has not healed properly raises concerns about infection, especially if there are signs of increased warmth, redness, or pain. The small red spots on your calf could also indicate a possible reaction or infection.

Wound Care Recommendations
1. Keep the Wound Clean: Ensure that the wound is kept clean and dry. Follow the instructions provided by your healthcare provider regarding dressing changes. If you notice increased redness, warmth, or discharge, seek medical attention promptly.

2. Monitor for Signs of Infection: Be vigilant for symptoms such as fever, increased pain, swelling, or any unusual discharge from the wound. If these occur, it is crucial to consult a healthcare professional immediately.

3. Elevation and Rest: Continue to elevate your ankle above the level of your heart as much as possible, especially when resting or sleeping. This can help reduce swelling. Avoid putting weight on the injured foot until you receive clearance from your doctor.

4. Compression: If advised by your healthcare provider, consider using a compression bandage to help manage swelling. However, ensure that it is not too tight, as this can impede circulation.

5. Ice Therapy: Applying ice packs to the swollen area for 15-20 minutes several times a day can help reduce swelling and alleviate pain. Always wrap ice packs in a cloth to prevent skin damage.

Rehabilitation and Recovery
1. Gradual Weight Bearing: As your swelling decreases and your pain improves, your doctor may recommend gradually increasing weight-bearing activities. Use crutches or a walker as needed to avoid putting too much pressure on the injured ankle.

2. Physical Therapy: Once the acute phase of swelling and pain has subsided, consider engaging in physical therapy. A physical therapist can guide you through exercises to restore range of motion, strength, and function to your ankle.

3. Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help manage pain and reduce inflammation. Always follow the recommended dosages and consult your doctor if you have any concerns.

Potential Complications to Watch For
1. Deep Vein Thrombosis (DVT): Given your limited mobility, there is a risk of developing blood clots in the legs. Symptoms may include swelling, pain, and warmth in the calf. If you experience these symptoms, seek medical attention immediately.

2. Cellulitis: This is a bacterial skin infection that can occur if bacteria enter through the wound. Signs include increasing redness, swelling, warmth, and pain around the wound. If you suspect cellulitis, contact your healthcare provider.

3. Chronic Swelling: If swelling persists beyond the expected recovery time, it may indicate underlying issues that need to be addressed, such as lymphatic drainage problems or chronic venous insufficiency.

Conclusion
Your recovery from a car accident injury requires careful monitoring and proactive management of your symptoms. Follow your healthcare provider's recommendations closely, and do not hesitate to seek further medical attention if your condition does not improve or worsens. With appropriate care and rehabilitation, you can work towards regaining full function and minimizing complications.

Similar Q&A

Managing Post-Accident Wounds: Treatment for Swelling, Blisters, and Scarring

Hello, doctor. In mid-July, I underwent surgery for a tibial fracture reduction and interlocking nail fixation following a car accident. During the period from the accident to the surgery, my leg swelled due to the fracture, resulting in multiple blisters in various areas. Curren...

Dr. Li Zhonghuai reply Surgery
Hello! The photos show that the wound is healing well, but you have a tendency to develop keloids. It is recommended to use scar gel promptly, wear long sleeves and long pants tightly when going out, apply sunscreen, and carry an umbrella for shade. If there is no improvement, co...

Post-Car Accident Wound Care: Managing Infection and Swelling

Hello Dr. Peng, I sustained an injury to my ankle from a car accident. On the third day, I noticed some redness and swelling around the wound. When I returned to the orthopedic clinic the next day, the doctor prescribed antibiotics for three days. However, after taking them for ...

Dr. Peng Xianwen reply Surgery
Hello Ms. M: 1. Taking antibiotics will definitely have an effect, but it is essential to completely control the infection in daily life. 2. The color of the scab or subcutaneous tissue with secretions. 3. Elevating the legs can help alleviate symptoms. 4. No, you can walk. For y...

Managing Persistent Swelling After a Motorcycle Accident: Expert Advice

Hello Doctor, I was involved in a motorcycle accident where my entire right calf was compressed, resulting in a deep wound on the outer side of my right ankle. The wound has not yet healed. I have bruising from my knee down to my ankle and foot. Four days after the injury, my ank...

Dr. Xu Kaixi reply Surgery
Based on your description, if you have been taking medication and paying attention to your daily activities, it seems that you are lacking in rest. Additionally, you may want to consider an evaluation and treatment from a rehabilitation specialist.

Post-Accident Knee Swelling: When to Consider Surgery and Recovery Tips

Hello Dr. Chen, I was involved in a car accident at the end of January 2022, which resulted in a fracture of my kneecap and contusions in the surrounding tissues. Since it was a minor fracture, the doctor recommended a cast and the use of crutches. After the New Year, I noticed s...

Dr. Chen Bochen reply Orthopedics
Hello, based on your symptom description, there are two possible conditions (not excluding other possibilities): 1. Lower extremity venous thrombosis 2. Local congestion and poor circulation after fracture healing. For both conditions, it is recommended to increase activity and p...