THIN SKIN UPDATE

[jules1955]

Hi All, quick update on skinned shin. I have seen the nurse for dressings twice now and last time she took a swab to check for infection. She said that she didn’t think it was - but just in case. It doesn’t look any better to me and I just can’t get my head around keeping it covered and moist. ( let the air get to it and it will scab over ) another appointment tomorrow afternoon for re-dressing. I’m worried that this will develop into something dreadful. ☹️

[jinasc]

Manuka Honey Cream (developed in Cambridge) can help healing.

Manuka Honey provides a natural antibacterial layer which blocks many infectious types of bacteria.

It is expensive but I used it all the time and still use it when necessary.

When you can also ask your GP to prescribe Double Base Gel - if they will not (as some do) then you can buy it. Just remember to follow the directions on the label. I used it after another patient told me about it. I still use it 14 years later.

Green Lipped Mussel cream also is excellent.

[PMRpro Ambassador in reply to jinasc]

But none of them on open wounds except the manuka honey cream and even then be careful to to contaminate the stock of cream.

[jules1955 in reply to PMRpro]

Hi PMRpro, sorry didn't understand "be careful not to contaminate stock of cream ?

[PMRpro Ambassador in reply to jules1955]

Don't put cream on the wound with your finger and then dip it in the pot/end of the tube again. Might be something on the finger that gets onto the bulk of the cream or the container. Does that make sense?

[jules1955 in reply to PMRpro]

Yes it does, thank you

[PMRpro Ambassador in reply to jules1955]

There may not BE anything nasty but better to be sure.

[DorsetLady PMRGCAuk volunteer]

As jinasc says Manuka honey ointment/cream excellent for healing, especially helpful when on Pred. Get medical version, and also MH medical dressings available on well known online store - not cheap, but worth it…as the saying goes.

[SnazzyD]

Without seeing the wound it is hard to comment. Generally if there is tissue loss that needs to grow back it is best to keep the wound moist because the meaty bit doesn’t like growing dry. “That is why scabs form!” I hear you cry. True but sometimes one needs to keep an eye on a wound bed in case it stops growing properly. Scabs can hide all manner of problems including ulcers that can cook away under a scab getting deeper. It is a judgment call as to which healing method is most appropriate.

[Kendrew]

Hi there. There is a school of thought that says that blood vessels can regenerate faster and the cells that cause inflammation drop faster when wound is kept moist and covered and not immediately exposed to the air. The treatment will obviously be determined by the type of wound suffered and in your case the nurse has deemed 'moist & covered' as the most appropriate course of action. As Snazzy has already said... scabs in some instances can trap infection underneath and hide a multitude of other possible complications. Try and be patient with the healing process...remember it'll take longer than usual when on steroids. It will heal eventually but will take time.

[123mossie]

The type of dressing you have are excellent, although the wound will look messy when the dressing is changed. When it’s cleaned you should be able to see the healing taking place from the edges. It will improve at each dressing change. I agree it’s contrary to what we’d expect to do, we didn’t have these in the old days!

[jules1955 in reply to 123mossie]

Exactly x

[piglette]

I have a lot of trouble with thin skin and lesions. I was surprised that you should cover up the wound. In fact I insisted for the first one it be left in the open air and the result was an emergency debridement op under general anaesthetic. It took five months to heal. I spend an awful lot of time with the district nurse and the local surgery being patched up. I now have a “box” of bandages, plasters, scissors, medical honey, saline solution etc etc. at home.

[Manihiki]

I had a scrape on the side of my leg from banging against an open dish washer and it took over 6 weeks to finally get to a healing point. I had multiple visits to the nurse for dressing and two rounds of antibiotics. It was kept covered and moist and the nurse kept changing the type of dressing to wake it up. I also was told that elevating it as much as possible is critical because that part of the leg is so much harder to heal because of blood flow.

[jules1955]

I have just had a txt from my Doctors Surgery. The swab taken on Thursday shows infection and I have to pick up some antibiotics, hopefully this will help.

[Thelmarina in reply to jules1955]

It sounds as though you are having excellent care so try not to worry too much. xx

[Jackoh]

They do sound as if they are on the ball!! Xx💐

[Karenjaninaz]

Jules, my wounds looked dreadful for a long time and painful too. My wound doc did not encourage a scab; the dark scab like pieces over my wounds were dead tissue which need debridement. I had to use a lysing ointment to dissolve it.Manuka honey gel I used in the beginning; it debrides the dead tissue but there is a time I had to switch to hydrogel when the honey started to burn. Hydrogel soothes.

These wounds take weeks to months to heal at higher pred doses.

The current thinking is to keep wounds moist until almost healed - according to ny dermatologist.