A trainee performed sclerotherapy on my lower leg, while a PA injected my upper leg. Polidocanol was used. Though they worked simultaneously, they operated independently and without supervision. I now have a 4 x 4 inch second degree burn on my lower left leg. What can I do? How do I make it go away?
Triple antibiotic ointment and pain management
Published on Jul 11, 2012
You should follow up with your provider. They need to access the area to see what treatment, if any, you need. Some of these areas heal on their own, while others require wound care.
Published on Jul 11, 2012
Silvadene cream is needed.
Published on Jul 11, 2012
There really is nothing that you can do at this point to reverse what has already happened. Routine wound care is needed here to prevent the wound from getting infected. The chemical burn should eventually heal in time, but you will be left with a visible scar.
Published on Jul 11, 2012
I can't say I have ever seen that happen before, but usually burns like that mean that the sclerosing agent didn't even make it in the vein, it just stayed in the surrounding tissue and damaged it. They did a terrible job with the injections because that shouldn't happen at all, even using 3% polidocanol. Was the sclerotherapy done via ultrasound? I would go back to the clinic to have it documented and treated. That is a good size of skin to has been burned. Keep the burn covered with non-stick gauze called Tefla pads, and maybe a loose ace wrap. Burn ointment wouldn't be a bad idea, but a 2nd degree burn is usually treated with antibiotic creams to prevent infection.
Published on Jul 11, 2012
It is likely that you do not have a burn, but a blister resulting from extravastion of sclerosant (they missed the vein). This can progress to an ulceration and heal with a scar. Keep wearing stockings and get rechecked ASAP.
Published on Jul 11, 2012
I am sorry to here that. That is unfortunate. It really needs to be seen by a doctor (dermatologist, plastic, general or vascular surgeon) or someone with experience in wound care to determine if its a second degree burn or full thickness skin necrosis. The treatments would be different.
Published on Jul 11, 2012
I am so sorry you are having trouble. I would advice you to get it checked immediately. If it is a burn, it may get infected.
Published on Jul 11, 2012
You probably have cutaneous necrosis, or a chemical burn from an injection. Once the damage is done there is very little that can be done to shorten the long healing time (months). Debridement in the office (removal of the dead tissue or dark center) should help. Also, keeping the area clean and dry to prevent infection is wise. Applications of topical antibiotics is not necessary and should be avoided after a few days. Systemic antibiotics are useless unless secondary infection sets in. Although cutaneous necrosis can happen even in the most experienced hands, it is more likely when novices perform treatment. Because your affected area is so large, consider seeing a plastic surgeon very soon.
Published on Jul 11, 2012
There must be a physician associated with the practice who can evaluate and treat this wound. Anyone who does a lot of sclerotherapy will eventually get an ulceration from extravasation, even if the physician has experience.These areas are usually very small and heal well. You have a large area which needs to be kept clean (soap and water is as good as anything). Some sort of salve, such as silver sulfadiazine, will help as well.
Published on Jul 11, 2012
Follow up with your MD. These generally heal with time, but yours sounds like a large area and needs close follow up.
Published on Jul 11, 2012
Consult a well-trained wound care center physician, or consider consulting a plastic surgeon who may be able to excise the wound with minimal scarring.
Published on Jul 11, 2012
The burn you describe is large. This is certainly a very unusual complication. I would treat this as any second degree burn and apply topical Silvadene cream. Burns such as these take time to heal. You really should have this looked at by a surgeon or by someone with burn treatment experience.
Published on Jul 11, 2012
A wound care specialist will best be able to serve you. He/She can recommend treatments that minimize the appearance of the burn or rid it all together over time.
Published on Jul 11, 2012