Why Your Wounds Struggle to Heal After Taking These Medications

After taking these medications, the wounds all over my body have become very difficult to heal?

Hello, doctor.
In May 2017, I had a car accident that caused the entire nail of my right big toe to fall off.
The toenail has been slowly growing back, but once while washing my feet, the wound accidentally came into contact with tap water, resulting in mild swelling of my right big toe.
It wasn't very swollen, but compared to the big toe on my other foot, it was red and slightly swollen, although there was no pain.
I visited several doctors, some of whom believed it was not serious and advised to leave it untreated, while others insisted that I needed to have the toenail removed because the new nail was thick and had an unusual shape.

In April of this year, I went to see a doctor again due to the redness and swelling of my right big toe.
By this time, the nail had completely grown back but was still thick, and the toe remained red and swollen.
A surgeon prescribed the following medications for me to take three times a day for a week, after which I was to return for a follow-up:
- Cephradine 250 mg capsules
- Broen-C 20000U + 20 mg tablets
- Debarilin 500 mg tablets
I only took the first two medications, the antibiotic and the anti-inflammatory, but I did not take the third pain medication because I did not experience any pain.
Upon returning for a follow-up after a week, my right big toe was still red and swollen with no improvement.
The doctor suggested that I consider having the toenail removed, and if I wanted to proceed, I could schedule another appointment with him.
I decided to cancel that day's appointment because I felt that I had finally grown back my toenail and did not want to remove it.
However, I noticed that after finishing the seven days of medication, even a small injury would lead to persistent inflammation that was difficult to heal.
For example, if I got bitten by a mosquito and scratched it, the small wound would become inflamed and hard to heal.
The same thing happened when I washed my hair; my scalp would also become red and swollen.
Any minor external injury would result in ongoing redness and inflammation, making it hard to heal.
This has been the case since April of this year, and it continues to this day.
I would like to ask, what should I do now?

Qiezi, 40~49 year old female. Ask Date: 2018/12/02

Dr. Peng Xianwen reply Surgery

Your description is very detailed and impressive.
To be honest, I really need to see your nails in person to advise you on the next steps.

Reply Date: 2018/12/02

More Info

It sounds like you are experiencing a frustrating and painful situation with your right big toe, particularly after the trauma of losing your toenail and the subsequent treatments. The persistence of redness and swelling, even after taking antibiotics and anti-inflammatory medications, can be concerning. Let's break down the potential reasons for your ongoing issues and explore some possible next steps.

Firstly, the medications you were prescribed, including Cephradine (an antibiotic) and Broen-C (an anti-inflammatory), are typically used to manage infections and inflammation. However, if your toe remains red and swollen despite this treatment, it suggests that there may be other underlying issues at play. Here are a few possibilities:
1. Infection: Even with antibiotic treatment, some infections can persist or may not respond to the specific antibiotic prescribed. If the infection is caused by a resistant strain of bacteria, it may require a different antibiotic or a longer course of treatment.

2. Inflammatory Response: Your body may be having an exaggerated inflammatory response to the injury. This can happen if the tissue is still healing or if there is ongoing irritation, such as from the thickened toenail or from friction against footwear.

3. Nail Growth Issues: The abnormal growth of your toenail could be contributing to the problem. A thickened or misshapen nail can cause pressure on the surrounding skin, leading to inflammation and pain. If the nail is ingrown or not growing properly, it may need to be addressed surgically.

4. Underlying Conditions: Conditions such as diabetes or peripheral vascular disease can impair healing and increase the risk of infections. If you have any underlying health issues, they could be affecting your recovery.

5. Allergic Reaction or Sensitivity: Sometimes, topical treatments or even materials in shoes can cause allergic reactions, leading to redness and swelling.

Given that you have been experiencing these symptoms for several months, it is crucial to seek further evaluation. Here are some recommendations for your next steps:
- Follow-Up with a Specialist: Consider seeing a podiatrist or a dermatologist who specializes in nail and skin conditions. They can provide a more thorough examination and may suggest imaging studies (like an X-ray) to rule out any underlying bone issues or infections.

- Consider Nail Removal: If the nail is causing ongoing problems, it may be worth discussing the option of nail removal with your doctor. While it may seem drastic, it could provide relief and allow for proper healing of the underlying tissue.

- Wound Care: Ensure that you are keeping the area clean and dry. If you notice any signs of infection (increased redness, warmth, pus, or fever), seek medical attention promptly.

- Medication Review: Discuss with your doctor the possibility of adjusting your medications. If you are experiencing persistent inflammation, they may recommend a different anti-inflammatory or a longer course of antibiotics.

- Monitor for Other Symptoms: Keep track of any other symptoms you may experience, such as fever, increased pain, or changes in the appearance of the wound. This information can be helpful for your healthcare provider.

In conclusion, while it can be disheartening to deal with ongoing issues after an injury, there are steps you can take to address your concerns. Seeking specialized care and potentially considering surgical options may provide the relief you need. Remember, healing can take time, and it’s essential to advocate for your health and well-being throughout this process.

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