Treating an open wound from schlerotherapy

Sclerotherapy . 8 answers . 3 years ago

The Dr. re-injected a vein, and the solution didn't enter. The next day the injection site had blisters and then later drained onto the stockings. Two weeks later the open wound was treated with antibiotics, and four months later it's still open, ugly, dark, and keloidish. How would you treat the wound & the scar?

ANSWERS


2 years ago by General Vascular Surgery Group (View Profile)

Local care and perhaps topical antbiotic ointment and time, they generally heal over time. Continue follow up eithban MD as well.

Michael D. Ingegno

2 years ago by General Vascular Surgery Group (View Profile)

Local care and perhaps topical antbiotic ointment and time, they generally heal over time. Continue follow up eithban MD as well.

Michael D. Ingegno


2 years ago by Arizona Vein and Laser Institute & Cosmetic Surgery (View Profile)

The ulcer has to be evaluated by a surgeon. If it doesn't close,
which it should have by now, there might be some other reason causing
the delayed healing.

2 years ago by Arizona Vein and Laser Institute & Cosmetic Surgery (View Profile)

The ulcer has to be evaluated by a surgeon. If it doesn't close,
which it should have by now, there might be some other reason causing
the delayed healing.


2 years ago by Bella MD Laser Vein and Aesthetic Center (View Profile)

Complex problem. Discuss with treating MD.

David A. Engleman M.D.

2 years ago by Bella MD Laser Vein and Aesthetic Center (View Profile)

Complex problem. Discuss with treating MD.

David A. Engleman M.D.


2 years ago by Angelo N. Makris MD (View Profile)

I suggest follow-up with a wound care center.

2 years ago by Angelo N. Makris MD (View Profile)

I suggest follow-up with a wound care center.


2 years ago by Vein Specialists (View Profile)

First thing to do is make sure there is not underlying insufficiency in the
deeper veins. Have you had an ultrasound? If you have not then you need to
get one by someone who knows veins. Registered Vascular technologist (RVT)
in a reputable vein specialist center. I am a vascular surgeon and have a
bias toward surgeon vein specialists as opposed to medical vein specialists.
If you have leaking veins underneath the ulcer or pressuring the area around
the ulcer these should be treated to expedite the wound healing. Until then
elevation compression hose or ace wraps and daily silver sulfadene
(silvadene) cream to keep the ulcer moist).

2 years ago by Vein Specialists (View Profile)

First thing to do is make sure there is not underlying insufficiency in the
deeper veins. Have you had an ultrasound? If you have not then you need to
get one by someone who knows veins. Registered Vascular technologist (RVT)
in a reputable vein specialist center. I am a vascular surgeon and have a
bias toward surgeon vein specialists as opposed to medical vein specialists.
If you have leaking veins underneath the ulcer or pressuring the area around
the ulcer these should be treated to expedite the wound healing. Until then
elevation compression hose or ace wraps and daily silver sulfadene
(silvadene) cream to keep the ulcer moist).


3 years ago by Vanish Vein and Laser Center (View Profile)

Most likely you had escape(extravasation) of the injecting fluid resulting in inflammation an ulcer formation. After 4 months of non(poor) healing I would recommend excision of the area and primary closure.

3 years ago by Vanish Vein and Laser Center (View Profile)

Most likely you had escape(extravasation) of the injecting fluid resulting in inflammation an ulcer formation. After 4 months of non(poor) healing I would recommend excision of the area and primary closure.


2 years ago by Vein and Vascular Diagnostic and Treatment Center, Cardiovascular Consultants of South Florida (View Profile)

If you have had it this long see a wound doctor.

2 years ago by Vein and Vascular Diagnostic and Treatment Center, Cardiovascular Consultants of South Florida (View Profile)

If you have had it this long see a wound doctor.


2 years ago by North Shore Vein Center (View Profile)

You are correct that a major cause of ulceration is extravasation during injection. These caustic solutions can destroy tissue and the degree of destruction is related to the quantity extravasated and the concentration of the solution.

Fortunately, these ulcers are fairly small and will eventually leave an acceptable scar. The wound should be debrided and treated with a hydrocolloid dressing to remove any necrotic debris. In addition to topical therapies, elevation of the extremity as much as possible along with Pentoxifylline may help limit the ulcer size and speed healing.

Dr. Mark Schwartz

2 years ago by North Shore Vein Center (View Profile)

You are correct that a major cause of ulceration is extravasation during injection. These caustic solutions can destroy tissue and the degree of destruction is related to the quantity extravasated and the concentration of the solution.

Fortunately, these ulcers are fairly small and will eventually leave an acceptable scar. The wound should be debrided and treated with a hydrocolloid dressing to remove any necrotic debris. In addition to topical therapies, elevation of the extremity as much as possible along with Pentoxifylline may help limit the ulcer size and speed healing.

Dr. Mark Schwartz

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