Wound healing difficulties?
Hello Dr.
Zhou: I have visited your clinic and would like to ask what to do if my wound has not healed for two weeks.
There is white hard skin on my leg; is this white dead skin stuck to the flesh? No matter what I do, it won't come off, and applying neomycin ointment doesn't seem to help.
I haven't squeezed the wound, and I'm not sure if I need to see Dr.
Zhou again.
I'm feeling quite helpless, and the doctor always laughs at me.
Please help me, thank you.
Here is a photo of the white hard skin: https://imgur.com/a/svttpf8.
No matter what I do, it won't come off.
Is this a biofilm wound? Should I use a debridement gel, perhaps the Clear-Derm dressing with the mushroom head? Or should I use Aquacel-Ag+ dressing or paraffin gauze? I really don't know what to do.
I tried using the debridement gel, but it resulted in redness and swelling.
Thank you, doctor.
Miss Tang, 40~49 year old female. Ask Date: 2018/08/14
Dr. Zhou Hongzhang reply Plastic Surgery
1.
Please come back to my clinic for a follow-up.
2.
Photos cannot be viewed online.
3.
Sometimes, certain dressings can cause allergic reactions.
Additionally, excessive interference with the wound can lead to delayed healing.
Reply Date: 2018/08/14
More Info
When dealing with non-healing wounds, especially those that have persisted for two weeks or more, it is crucial to understand the underlying factors that may be contributing to the delayed healing process. Non-healing wounds can be a source of frustration and anxiety, and they often require a comprehensive approach to treatment and care.
Firstly, it is essential to assess the wound's characteristics. The presence of white, hard skin around the wound may indicate necrotic tissue or a biofilm, which can impede healing. Biofilms are clusters of bacteria that adhere to the wound surface and can be resistant to antibiotics and other treatments. If the wound has a significant amount of necrotic tissue, it may need to be debrided, which is the process of removing dead or infected tissue to promote healing.
In your case, since you mentioned that the wound has not healed despite the application of ointments like Neomycin and the presence of hard white skin, it may be beneficial to consult a healthcare professional for a thorough evaluation. A medical professional can determine whether the wound requires debridement or if there are other underlying issues, such as infection or poor blood circulation, that need to be addressed.
In terms of wound care, here are some expert tips that may help facilitate recovery:
1. Keep the Wound Clean: Regularly clean the wound with saline solution or mild soap and water to remove any debris or exudate. Avoid using harsh antiseptics that can irritate the tissue.
2. Moisture Balance: Maintaining a moist wound environment is crucial for healing. Dressings such as hydrocolloid or alginate can help keep the wound moist while absorbing excess exudate. Products like Aquacel-Ag+ can also provide antimicrobial properties, which may be beneficial if there is a risk of infection.
3. Debridement: If there is necrotic tissue present, debridement may be necessary. This can be done surgically or through the use of enzymatic debriding agents. It is essential to have this performed by a qualified healthcare provider to minimize the risk of further injury.
4. Monitor for Infection: Watch for signs of infection, such as increased redness, swelling, warmth, or discharge. If you notice any of these symptoms, seek medical attention promptly.
5. Nutritional Support: Ensure you are consuming a balanced diet rich in vitamins and minerals that support wound healing, such as vitamin C, zinc, and protein.
6. Avoid Pressure: If the wound is located on a weight-bearing area, consider using padding or specialized dressings to relieve pressure and prevent further injury.
7. Follow-Up Care: Regular follow-up with a healthcare provider is essential for monitoring the wound's progress and making necessary adjustments to the treatment plan.
8. Psychological Support: It's not uncommon to feel anxious or frustrated about non-healing wounds. Consider seeking support from a mental health professional if these feelings become overwhelming.
In conclusion, non-healing wounds require careful assessment and management. If you are experiencing persistent issues with your wound, it is advisable to return to your healthcare provider for further evaluation and treatment options. They can provide tailored advice based on the specific characteristics of your wound and your overall health status. Remember, healing takes time, and with the right approach, improvement is possible.
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