Just try to keep INR around 2, I dare you!

[pellicle]

best wishes your way Gail

 

[Bina]

Gail, how is this all working out now ? Hope all is well

 

[Gail in Ca]

Went in to have the doc look at it, because I'm not so sure what "healed" looks like. She took one look at it and said she wasn't happy about one small opening, so she cultured it and another duoderm patch was placed. It actually had been looking all closed up last week, but in the harsh lights off the exam room, it looked more red and one tiny hole was open. Will find out Thurs if it's infected.
Also, I asked her about whether INR being 2 or 3 had much to do with it taking so long to heal. She said she didn't think so, just being on warfarin made healing much longer in her patients, and mine being on the leg makes for another negative, as leg incisions take longer to heal as well, less circulation. She did say I could start to exercise now, but slowly. It does look better than I thought it would, not as horrible as it seemed many weeks ago. I can look at it again in a week.

 

[pellicle]

it looked more red and one tiny hole was open. Will find out Thurs if it's infected.
...
Also, I asked her about whether INR being 2 or 3 had much to do with it taking so long to heal. She said she didn't thin. It does look better than I thought it would, not as horrible as it seemed many weeks ago. I can look at it again in a week.

Sounds on the improve best wishes

 

[Gail in Ca]

Well, it sounded good, but I knew within a few days of stopping the Keflex, my infection was not gone. My culture came back positive. I've asked my doc if she would talk to my infectious disease doc. She didn't know last night if it was the same bacteria, but said I could probably go on Keflex AGAIN, but now QID for 10 days! Or, I could put clindamycin topically TID, and bleach baths twice a week. I gave her my thoughts, so I'm waiting to see. I didn't want to take Keflex again, it doesn't seem to be killing it now does it? But, I'm concerned about just treating topically because it is still painful. Crapola.....

 

[pellicle]

Infections can be stubborn things.

As long as its there it won't close. That its not closed is itself an indication that its there.

Is anyone using silver based dressings there?

 

[pellicle]

Hi

as you may recall I had an open wound for some months (well surgeons had a hand in opening and then reopening it) and Aquacel was used in my wound dressings.

There was no infection in my wound (only the one under / in the sternum)

http://www.ncbi.nlm.nih.gov/pubmed/17199764

Dressings have a part to play in the management of wounds; whether they are sutured or open, usually chronic wounds of many aetiologies which are healing by secondary intention. They traditionally provide a moist wound environment, but this property has been extended through simple to complex, active dressings which can handle excessive exudate, aid in debridement, and promote disorganised, stalled healing. The control of infection remains a major challenge. Inappropriate antibiotic use risks allergy, toxicity and most importantly resistance, which is much reduced by the use of topical antiseptics (such as povidone iodine and chlorhexidine). The definition of what is an antimicrobial and the recognition of infection has proven difficult. Although silver has been recognised for centuries to inhibit infection its use in wound care is relatively recent. Evidence of the efficacy of the growing number of silver dressings in clinical trials, judged by the criteria of the Cochrane Collaboration, is lacking, but there are good indications for the use of silver dressings, to remove or reduce an increasing bioburden in burns and open wounds healing by secondary intention, or to act as a barrier against cross contamination of resistant organisms such as MRSA. More laboratory, and clinical data in particular, are needed to prove the value of the many silver dressings which are now available. Some confusion persists over the measurement of toxicity and antibacterial activity but all dressings provide an antibacterial action, involving several methods of delivery. Nanocrystalline technology appears to give the highest, sustained release of silver to a wound without clear risk of toxicity.

 

[tom in MO]

I agree, why stick with what does not work. I had a bad colon infection and when through a host of things, finally had to have it cut out; same with a friend and a lung infection. Bleach baths sound like the nuclear approach, i.e. broad spectrum killer of bugs. If you haven't tried it, maybe it's time.

 

[clay_from_nj]

Pellicle-
Funny you bring up silver and its use in wound care. As a teenager, just over 30 years ago, I was in a pretty bad bicycle accident (nothing broken, but lost some skin) and one of the things prescribed to me was a silver-based cream (silvadene?) which seemed almost miraculous in hastening the healing process. I had some left over and used in on my normal teenage "zits" which were almost always gone overnight. I certainly wish I could find that stuff again, if only to keep some in the first aid kits.


Ha! I just Googled Silvadene and found information on it all over the place. I know I've searched even a couple of years ago and could find nothing. It does look prescription-only, though.

 

[Gail in Ca]

I am now on Keflex QID for 10 days, and a bleach bath every day. I'm told the bleach baths really work to kill s. aureus.
She thinks I was re-infecting myself somehow. Also, no more patch, I'm to leave it open to dry out.
I remember Silvadene when I worked as a pharmacy tech many yrs ago.
She didn't want to give me another antibiotic because she said it raises INR out of therapeutic range. I told her I had my own machine and could watch it closely, but got Keflex again. Wish me luck. On the bright side, my INR has been on the low side of normal for 2 weeks.
Oh Dear, I just took off the patch to take my 1st bleach bath and my wound is now 4 openings not 1 small one and only since tues!
That staph wants to do me in! Luckily the bleach bath didn't sting. So, I'm good to go.