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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?
Local care and perhaps topical antbiotic ointment and time, they generally heal over time. Continue follow up eithban MD as well.
Michael D. Ingegno
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.
Complex problem. Discuss with treating MD.
David A. Engleman M.D.
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).
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.
If you have had it this long see a wound doctor.
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