Leg ulcers after cellulitis

[Loramay]

Hi I have lipoedema with secondary lymphoedema and I'm hoping for some advice on the best treatment for leg ulcers after a bout of cellulitis at the beginning of May. They were getting better when my new compression juzo wraps arrived after a few weeks my ulcers started to get bigger. The lymphoedema clinic didn't want to see me but advised me to get them to do compression bandages as they worked better on open wound and 3/4 weeks ago they started leaking lymphatic fluid. One morning woke up with a leg so red you could have got sunburn from it,no temperature nor was the leg red hot,but I removed the bandages anyway explained to the practice nurse who smothered me in barrier cream and put the compression bandages back on, asking me very nicely to leave them alone.

Next morning having not slept I phoned the surgery spoke to the nurse and explained the situation and could they find something else as I couldn't cope with the compression bandages and I was asking their permission to remove them and from now on I would wear my sigvaris combi flex wraps again as I didn't feel the juzo were giving me any compression. 4 weeks on its still leaking, we have moved on from zipzoc to aquacel plus some brown mesh that has silver in it.

Over the last few days after a remark from my mom about how have always had sensitive skin I have tested everything we have or are using on my ulcer

Red marks within 10 minutes compression bandages, petroleum jelly, clinderm dressing,

Reaction within 30 minutes zetuvit sterile dressing (I have since found out that they use latex based glue on the packaging plus double bass and another cream like that.

No reaction yellow line a cotton liner, some white fluffy bandages I don't know the name of, non sterile dressings, diprobase, zipzoc, aquacel and the brown silver impregnated mesh.

Currently my biggest saviour is my sigvaris wraps, zipzoc and non sterile dressings as I can wear them.

I am also take fentanyl patches 75mg gabapentin 300mg 2 3 times a day for osteoarthritis in both knees due to a motorbike accident 35 years ago and the spine . Plus I suffer from GAD and depression and take Venlafaxine and mirtazapine.

Last night was the worst in the early hours of morning I felt like I have had enough of this I really think that I can not take much more of this. So any ideas that I can take tomorrow when I see the nurses to redress my leg would be great especially as it looks like another sleepless night ahead

[Lynora]

Have they done a swab test to check if you have bacterial/viral/fungal infection?

The white fluffy bandages are known as ‘undercast bandages’ - I use Cellona, as it doesn’t tend to act like cotton wool and bunch up!

Ask to be seen by the local (they usually cover multiple practices) Wound Care or Tissue Viability Nurse or a domicillary lymphoedema Therapist.. If there is lymphorrhea (leaking lymph) but no infection, it may be better to use ultra absorbent dressings, no cream, to prevent the surrounding skin from macerating, and further breakdown.

Ask if you could have Level One Bandaging, as recommended in a document “The Chronic Oedema ‘Wet Leg’ (Lymphorrhea) Pathway, published by Lymphoedema Network Wales.

In an ideal world, the treatment should be done daily or at least every other day, to ensure the integrity of the skin.

[Duncjjan]

Hi Loramay. So sorry to hear about your abbess. I’ve got an Old wives cure. EGG WHITES just gently whisk then apply with your fingers It dries to seal the open sore and can be applied as required It actually saved a dogs leg that was about to be amputated as the sore wouldn’t heal Maybe worth a try Good luck X

[GabbiD]

I don't have anything to add to the two great responses. But good luck to you!

[Bermondsey_bill]

After several creams etc, my district nurse team finally settled on Medical Honey slowly the ulcers receded and eventually closed up. They then began compression bandaging of the lower leg, this had the effect of giving me a set of ballet dancers calfs, but pushed the fluid to around my kneed, upper leg and across the abdomen. My waist size has increased by about an inch a week and its all just fluid. Also the backs of my hamstrings seem to develop small blisters, which burst leaking - surprise, surprise lymphatic fluid.

[Loramay]

Thanks for that I am trying Lynora method at the moment which my practice nurses are not happy about as it goes against everything they have been taught but I have the right to say what I want done. Plus bed rest which until now I have not done from day one even with cellulitis I have done the usual housework etc the only time my leg was elevated was when I went to bed. Which the nurses didn't know so they have ordered me to bed. Hubby not too happy but I explained that they said the other option was I did it in hospital, he is going along with it.