A wound that won't heal: Doctors in the house?

[King Herald]

Nope, not an axe wound, but a 'sore' on the base of my nephews spine. He has had it a year now, and he's been off school for nine months, and still has the ulcer, or whatever it is, at the base of his spine.

He's been into hospital several times, had two skin grafts to try and seal it up, has a nurse come to his house every day to change the dressing, but it is still an open seeping wound about 8cm long, 1cm wide and 2cm deep.

He showers every day, eats good food, but none of this seems to make and difference.

I'd recommend he gets in the sea every day, sluice it with some good old brine, but he lives 100 miles from the nearest beach.

Any advice?

[E31Shrew]

I had a similar problem also. I then went swimming every day for a month and lo and behold it cleared up...Sorry to give you that detail this time of the morning!

[VxDuncan]

Leeches.

Might work...

[HRG]

Has he tried salt water baths?

[dave_s13]

That sounds very dodgy.

Can you not insist he has a second opinion from another dermatologist (assume that's who did the graft).

There's no reason for a young lad to have a chronic ulcer if he's otherwise fit and well.

[rich1231]

Have you seen or heard the actual diagnosis, as your description suggest he has already had one..

[turbobloke]

VxDuncan said:

Leeches.

Might work...

Maggots also have a good reputation for this sort of thing.

[King Herald]

dave_s13 said:

That sounds very dodgy.

Can you not insist he has a second opinion from another dermatologist (assume that's who did the graft).

There's no reason for a young lad to have a chronic ulcer if he's otherwise fit and well.

I have no direct contact with the guy, or his mum (my sister), just what I hear from my parents. He is 16, just failed his A levels as he has not been at school for nigh on a year, can't even sit down.

Is there some legal angle he can follow to rev up the NHS and get some 'better' attention?

And no, I don't want to hear about compensation's or 'Legal Feckwits R Us', but I would like to get him sorted as it is starting to stress my 70 year old parents.

[Pesty]

Pilonidal sinus disease ?

[littlegreenfairy]

Has he tried bathing it in a weak solution of tea tree oil?

Some people may find it hippyish, but it has got amazing antibacterial properties and just generally amazing.

Or what about getting it in lots of fresh air in the hope that it may dry out a little?

I'm no doctor (I may be a failed everything else, but I've never tried my hand at medicine!)

[Rach*]

http://www.worldwidewounds.com/2003/december/Mille...

Possibly. (Link NSFW, nasty pics)
If it is and this stage sounds like it needs wide excision

[shadowninja]

HRG said:

Has he tried salt water baths?

My thinking, too. Sprinkle a bit of salt in a bath of hot water (normal temp for a bath) and lie in it for 10 minutes, morning and night.

[HRG]

shadowninja said:

HRG said:

Has he tried salt water baths?

My thinking, too. Sprinkle a bit of salt in a bath of hot water (normal temp for a bath) and lie in it for 10 minutes, morning and night.

Little? When I had an infected wound in hospital they used to use about two cupfuls per bath...

[King Herald]

Pesty said:

Pilonidal sinus disease ?

rich1231 said:

Have you seen or heard the actual diagnosis, as your description suggest he has already had one..

I haven't heard any immediate diagnosis, just going on the history my parents have told me. My dad is the 'taxi service' who runs the nephew and his mum to the docs/hospital all the time, so I'm assuming he has been told as much relevant info as is available.

The hospital recently had to apply for extra funding to pay for some sort of suction device to keep the wound drained, which indicates it is an expensive bit of kit.

My sister is not happy with the way the whole thing has been treated, or by the attitude of the people involved, but she won't make any sort of an official complaint for fear it hinders his treatment.

It seems strange a wound like this can remain open for so long with modern medical treatment.

littlegreenfairy said:

Has he tried bathing it in a weak solution of tea tree oil?

Some people may find it hippyish, but it has got amazing antibacterial properties and just generally amazing.

Or what about getting it in lots of fresh air in the hope that it may dry out a little?

I'm no doctor (I may be a failed everything else, but I've never tried my hand at medicine!)

I know the good properties of tea tree oil, but whether he'd be prepared to try it is another issue.

[shadowninja]

HRG said:

shadowninja said:

HRG said:

Has he tried salt water baths?

My thinking, too. Sprinkle a bit of salt in a bath of hot water (normal temp for a bath) and lie in it for 10 minutes, morning and night.

Little? When I had an infected wound in hospital they used to use about two cupfuls per bath...

Depends on the amount of water, I would have thought.

[john_r]

It's unlikely to be an ulcer... Sounds like an infected Skin Gland and it can take months to go away. They are remarkably common - I had a small one under my arm, but luckily it 'vented' outwards and disappeared after a few days of intense pain; however a friend had one that was 4 inches across and nearly an inch deep on her back for 4 months! Without being too gross, think of it as similar to a zit on a giant scale - a skin gland/pore has got blocked and then infected and the infection has initially 'eaten' inwards rather than towards the surface of the skin.

There's not a lot the doctors can do except to change the dressing every day and rinse them with clean salt water. The dressing must stay dry so I hope the lad is not getting it wet when he showers? I also coated the skin around mine with antiseptic cream 2-3 times every day which helped with the pain considerably - try and get the one with a mild anaesthetic in it from the chemist?

Nasty condition and I hope it clears up soon.

and yes, 'venting' is as gross as it sounds!

[Jazzer77]

john_r said:

It's unlikely to be an ulcer... Sounds like an infected Skin Gland and it can take months to go away. They are remarkably common - I had a small one under my arm, but luckily it 'vented' outwards and disappeared after a few days of intense pain; however a friend had one that was 4 inches across and nearly an inch deep on her back for 4 months! Without being too gross, think of it as similar to a zit on a giant scale - a skin gland/pore has got blocked and then infected and the infection has initially 'eaten' inwards rather than towards the surface of the skin.

There's not a lot the doctors can do except to change the dressing every day and rinse them with clean salt water. The dressing must stay dry so I hope the lad is not getting it wet when he showers? I also coated the skin around mine with antiseptic cream 2-3 times every day which helped with the pain considerably - try and get the one with a mild anaesthetic in it from the chemist?

Nasty condition and I hope it clears up soon.

and yes, 'venting' is as gross as it sounds!

It had the same condition that quickly turned into an abscess.
GP sent me to hospital right away and they operated on it that day.

Reading the original post reminded me of it before it went Pete Tong , its something that the experts should deal with - get a 2nd opinion.

[garycat]

Isn't it possible to use a hydrocolloid dressing, they are available from Boots and allow open wounds to heal underneath a 'plastic' membrane. It worked for my dad when he had an open wound on his head about 2cm x 0.5cm that wouldn't close.

[vixta]

I haven't heard any immediate diagnosis, just going on the history my parents have told me. My dad is the 'taxi service' who runs the nephew and his mum to the docs/hospital all the time, so I'm assuming he has been told as much relevant info as is available.

The hospital recently had to apply for extra funding to pay for some sort of suction device to keep the wound drained, which indicates it is an expensive bit of kit.

My sister is not happy with the way the whole thing has been treated, or by the attitude of the people involved, but she won't make any sort of an official complaint for fear it hinders his treatment.

It seems strange a wound like this can remain open for so long with modern medical treatment.


depending on if it is a sinus or an ulcer will ultimately determine the healing process. sinuses do generally take longer to heal. In your nephews situation, may be a VACS ( vacum assisted closure system ) might help, but only if it has been diagnosed as an ulcer. VACS normally isn't advocated for sinuses unless investigations have been carried out to determine exactly where it is coming from. salt water baths, are generally a good thing to do. making sure he isn't lying on his back - common sense really from an every day perspective. in terms of dressings to be used, yes hydrocolloid dressings can work but this is dependant on the level of exudate from the wound. If it's mucky and exuding a debriding agent could work. If it's just exudate and it is copious amounts then a mobile VACS would help, but like I said, it does depend on whether it is a sinus or an ulcer.

HTH

[Simpo Two]

This is a known condition - my neighbour has had it for years it. He ended up having an operation and stitches, but it opened up again at one end (the wound is several inches long) and he's now back to where he started. The wound will not heal naturally because it is constantly moving, and he is forced to have salt water baths each day to prevent infection.

See your GP and get referred now!