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CathyA
12-3-20, 4:24pm
A couple months ago I showed my dermatologist a spot on my lower leg. I'd had it checked before and it said it was fine. But it changed color, so I saw him again. He took a biopsy and it was a melanoma in Situ....which is the earliest form of a very serious skin cancer. He referred me to a plastic surgeon about 30 miles from home. I went to him and because of the location on the lower leg, above the ankle, he said that it is common that it just doesn't have enough circulation to heal well. And the area was too large to suture shut.

He said I'd need a split-thickness graft over it. So I had surgery (general anesthesia), was put in a metal boot and couldn't move it for a week. I had to buy or rent various things during that time (scooter, walker, bed side commode). I did the very best I could. I returned in 1 week and only saw his nurse who removed the splint and dressing (of many staples, holding rubber bands across the pressure dressing). She said it looked good. I was to apply Silvadene daily and return in 1 week.

I saw the surgeon then and he said it didn't look good, but was a little hopeful. He said to stop the silvadene and apply sterile saline to gauze, covered with dry gauze and an ace bandage. I did this 3 times a day and it continued to never change......looking obviously like it had dead tissue over the wound (eschar). I saw him 2 weeks later and he said the graft had failed and I needed another one.......which may or may not work. This guy doesn't have the greatest bedside manner, but he's supposedly an excellent plastic surgeon and is one of the most knowledgeable melanoma people in the state.

But.....his nurse came into the room one visit without a mask and I had to tell her to put one one. At each visit the doc lowers his mask below his nose and mouth. DH has to remind him to pull the damned thing up.

The education they give me about wound care is lacking. I think I'm doing an excellent job of taking care of it though.

So.......at my last visit, I told him I'd go ahead with the re-do. The doc warned me we should get in ASAP, as the covid deaths in this state have topped 8,500 today and he thinks the surgery center will close soon. So.......they were to call me 3 days ago and haven't yet. Yes, I was going to call them, but I have this gut feeling that this isn't what I want to do again.

If they call for a surgery date, I think I will put it off until early January. Around xmas, there's too much I want to do, and at least the cancer is gone.

I don't have a lot of confidence in some medical people, and maybe that's my problem. But I just get the feeling I will repeat this and have the same low chance of it not working again. I don't care what it looks like when it's all healed.

So......anyone here have anything similar and have any of you treated a large open wound at home yourself? This wound is about 2"x1 and 3/4" round and about 1/4" deep.

I am not diabetic, I eat healthily. I would truly like to nurse this wound back to health myself.

I've researched some stuff online, but can't find much for do-it-yourself large wound care. I see it 3 times a day and would know if it gets infected. I'm a retired critical care nurse.

I appreciate any useful advice you can give me about your experience with something similar.
Thanks.

Teacher Terry
12-3-20, 4:34pm
Cathy, I am so sorry you are having so much trouble with this. I would probably get a second opinion.

CathyA
12-3-20, 4:44pm
Thanks Terry. I guess since my dermatologist (who I really like and trust), built up this surgeon so much, I felt hesitant to think anyone else would do better. But......your suggestion is a good one. I don't think waiting a couple weeks, to get through the holidays without being flat on my back will hurt much. So I'll be researching another doc in that time. Also, there are Wound Care places and doctors who would be reasonable to see. Thanks Terry.

herbgeek
12-3-20, 4:48pm
Any home remedies I might recommend, I wouldn't recommend for a wound that large. That needs professional care imo.

Oddball
12-3-20, 5:33pm
Sorry to hear about this. I agree that pro care is called for. I'm not a doc and can't recommend anything, but if it were me and I were at home alone with no immediate better option, I would try Boiron Calendula Gel from a health food store. It has alcohol and will burn, but I've seen it work well for bloody skin wounds that were slow to heal. This was for an elderly relative I suggested it to after some nurses put Vaseline on it and sent him home, which was useless. Again, not giving advice, just sharing what has helped me and a loved one.

KayLR
12-3-20, 5:49pm
Cathy, I feel/hear your frustration. I, too, recommend another opinion.

Tybee
12-3-20, 6:02pm
Cathy, first, I am so sorry you are going through this. Like Terry, I would say get another opinion, and actually, I would go to the wound care center and not back to the plastic surgeon.

I have read about using sugar to heal open wounds but have never tried it. This is an article about a study that tried using honey vs sugar and found honey better:

https://pubmed.ncbi.nlm.nih.gov/17708384/

frugal-one
12-3-20, 7:30pm
I have used "People's Paste" when I cut a chunk of my thumb while carving a turkey. It worked very well and there is no scar. I don't know how it would work in an area that was too large to suture shut???

dado potato
12-3-20, 8:23pm
Cathy:

I trust that the Wound Care places you mentioned would have a physician to examine your wound and treat it effectively. IMHO the sooner, the better.
They may have recommendations for home care measures you can take to encourage healing.

If I were in your situation, I would ask the MD what dressings they recommend, and do they recommend elevation?

To your healing and wholeness!

Tammy
12-3-20, 9:20pm
I’ve seen some really nasty wounds in our psychiatric patients, as many times they were homeless and psychotic and the wounds had no care for weeks because of their mental state. My favorite consult was to our wound nurses. They knew so much.

My cynical heart says the surgeon does surgery, so he recommends more surgery. I would ask the wound nurses. Especially since the cancer is gone, it’s not infected, and you don’t care if there’s a big scar afterward.

jp1
12-3-20, 10:29pm
My non medical expert opinion is that Tammy is spot on. The cancer is gone, it’s not infected, and it’s not an area of your body where an ugly scar will matter. I would be a bit more charitable about the surgeon, but she’s probably right. When you’re a hammer everything looks like a nail. When you’re a surgeon everything needs a surgical solution. I’d go to wound care to figure out how to get it to recover. And I’d go sooner rather than later since wound care is not as likely to include staying off your feet. Every day you wait is another day where the wound has a chance to get infected and become a problem.

Gardnr
12-3-20, 11:47pm
So......anyone here have anything similar and have any of you treated a large open wound at home yourself? This wound is about 2"x1 and 3/4" round and about 1/4" deep.

I am not diabetic, I eat healthily. I would truly like to nurse this wound back to health myself.

I've researched some stuff online, but can't find much for do-it-yourself large wound care. I see it 3 times a day and would know if it gets infected. I'm a retired critical care nurse.

I appreciate any useful advice you can give me about your experience with something similar.
Thanks.

Isn't your husband an MD? Can he manage this to recovery?

It's a really big wound IMO and I would not mess around with it. The longer it is open, the lower your chances of healing it and the higher the risk of infection.

Tammy
12-4-20, 12:27am
It’s also good to get the eschar dealt with - wound nurses are great at that too.

Tammy
12-4-20, 12:30am
And if they suggest epsom salt soaks I’ll smile. (It might work but don’t listen to me.)

The last few months my parents called me about various aches and pains and I’ve been advising them more than is typical for me, because it’s too risky to go to the doctor for non-urgent things. My dad had a swollen reddened area on his elbow and I suggested Epsom salt soaks. It actually worked. His elbow opened, drained, and then completely healed.

happystuff
12-4-20, 11:14am
Cathy, excellent suggestions from everyone. I agree with 2nd opinion and wound care dr. Wishing you quick healing.

nswef
12-4-20, 12:34pm
I, too, would suggest wound care. I had 3 weird holes in my foot, dermatologist had me soak it in some aluminum thing and use aqua por? on it. Not better- they were about 1/2 inch around and 1/2 inch deep. He sent me to wound care and they cleaned it, and had me use aqua por only. It worked. I was impressed that the dermatologist suggested it and that it worked so well.

JaneV2.0
12-4-20, 1:11pm
And if they suggest epsom salt soaks I’ll smile. (It might work but don’t listen to me.)

The last few months my parents called me about various aches and pains and I’ve been advising them more than is typical for me, because it’s too risky to go to the doctor for non-urgent things. My dad had a swollen reddened area on his elbow and I suggested Epsom salt soaks. It actually worked. His elbow opened, drained, and then completely healed.

Epsom salts are good for many things--like a dental soak to help drain sockets after an extraction. Worked for my wisdom teeth when salt alone wouldn't touch them, anyway...

CathyA
12-4-20, 5:07pm
Thanks everyone. Lots of good suggestions. I tend to agree with some of you about surgeons......they do surgery. I need a break for a few weeks, so I'll wait until after christmas and see a wound specialist. Going anywhere during this pandemic is a bit disconcerting though. The daily rates of positive cases in our state is over 8,000 now. I'm just glad the melanoma is out. I'm taking good care of the wound and if it even thinks about getting infected, I'll see someone sooner.

The surgeon told me to use hibiclens on it, then said soap is okay. Do you think Castile soap would be okay? DH brought home a "foamer". They're so cool.....you put the hibiclens or liquid soap in there and it turns it into foam.....which is easier to use. Like I said, this surgeon's office isn't great on teaching. The nurse says different things than the doc. I'll really be glad to not go there.

Any suggestions for getting better blood flow to the lower leg? I'm thinking just putting my feet in very warm water might do that. I'm a big woman, but my ankles are tiny. They've got a big job to do. haha
Thanks again for your suggestions. I really appreciate it!

Gardnr
12-5-20, 1:26pm
The surgeon told me to use hibiclens on it, then said soap is okay. Do you think Castile soap would be okay?

NOOOOOOOOOOOOOOOO!!! Never hibiclens on open tissue! Ugh. In the operating room, the only solution we use on open tissue is betadine solution (Not soap). You can also use hydrogen peroxide.

JaneV2.0
12-5-20, 1:42pm
Though I haven't used one, vibration plates are reported to be great for circulation, though they may not be recommended for open wound situations.