This post is mainly a cautionary tale. Many of us have thin skin; steroid age related etc. My skin on shins has become very thin in the last 12 months and two weeks ago, my dogs claw caught the front of my shin. It was something and nothing, but it caused a skin tear about 1” by 1.5” right on the bone. It bled profusely (thanks Apixabin anticoagulant). I washed the wound immediately and then compressed a wet dressing to stem blood flow and later dressed and covered the wound. It bled again the following day when I changed the dressing, but looked clean. Redressed and repeated over the next week. No sign of the wound healing, so after 7 days I saw practice nurse who dressed and suggested compression stocking to aid healing. Was told to return in 3 days to be checked. I noticed my foot was very swollen and my leg and wound area felt hit the day before return visit, so I took the stocking off.
Saw nurse yesterday and realised there was a problem when she said I need a doctor to see this. Bottom line is wound is infected, whole leg is swollen and now at risk of clot or sepsis. Have started a course of antibiotic with instructions to monitor symptoms until I return on Friday. Doctor said it couldn’t have happened in a worse place and it’s going to need a lot of attention and tlc in coming months. High chance of ulceration.
I have to say I never expected anything like this. It seemed insignificant and I’ve always healed well and quickly so this is a salutary reminder that we’re under the cosh. It’s another lesson and if I ever get anything similar, I’ll seek immediate medical attention. I didn’t because I thought it was something and nothing. I’m sharing as it could happen to anyone and it’s a clear waning to take care.
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Hulotsholiday
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Oh bad luck. Yes, the shin can be tricky place to heal at the best of times. I’ve seen skin tears aplenty there and yes, even a small nick can become a bigger problem but often you don’t know until it happens. It is unfortunate you were also on anti clotting meds. Your approach wasn’t silly at all but sadly the tissue viability goalposts moved and you didn’t get the memo. Hope things get better with more intervention. 💐
I caught the front of my shin on the sharp corner of a coffee table at the start of my holiday here. It bled nicely and we covered it immediately, being fairly careful about aseptic precautions, that daughter is an ACP in the ED. The dressing change was done by the other *nurse) daughter - with VERY aseptic technique. I've been lucky, no infection but she was very concerned about it. The only mistake we made was not to nip up to MIU - they would probably have used steristrips and it would have healed better.
But yes - not a place to be messed about with. Hope it is OK.
Thanks PmrPro. I thought I’d done the right thing in immediate care, so this has really caught me off guard. I had it covered with sterile wound dressings but had to abandon those as the sticky bit was causing subcutaneous bruising when I removed them. I tried steri strips to stick a bandage to skin but they caused bruising too. Now it’s dressings and bandage with nothing stuck to skin. I’m taking a couple of days out with leg elevated lying on sofa and boxed sets on tv.
What an excuse!!!! I got a bit of sub cut bruising where the sticky edge was but it has faded very quickly. Just the hard dry scab where the edges were further apart than ideal. The one before - a couple of years ago - had stitches (I was at a rheumy OP appointment when I did and was sent the ED where a surgeon stitched it!) so was smaller. But hadn;t thought this needed it - and it was a hell of a long way to an ED.
Get a supply of this stuff for just in case - cohesive bandages
Thanks for the bandage link. I haven’t seen or used that stuff but it looks useful. I’m not risking any more sticking stuff directly to skin. I’ll get some next time I’m out. 👍😀
The last injury to my shin took just under 3 months to heal. The last one on my arm 2 months. I did go to the surgery the day after each one. I wear arm protectors on both my lower legs when I’m near my son’s very lively dog and even my own sedate 10 year old cocker spaniel can catch me on the arm when excited to see me. It’s no fun wearing them on a day like today but I can’t risk that happening again.
Thanks for the warning. I didn’t realise it may take so long…oh my days! I’m hoping rest, elevation and the antibiotics will kick in soon. It’s still very inflamed and throbbing.
Let’s hope so. Just another problem with this unpleasant disease. However I keep telling myself there are lots of people so much worse off. Keep trying to stay positive . 😀😀😀
like you I take Apixaban and had a knock on my leg just above the ankle.
It was classed as a haematoma (a large black lump)
The doctor eventually used a scalpel to open the lump
It’s now about 12 weeks I am still attending doctors surgery every other day for wound dressings. I have had 4 lots of antibiotics and had been warned about Sepsis i.e any probs over weekends go straight to A&E
It is starting to heal now but I’ve still got a way to go.
I have had excellent treatment from the Doctors and Nurses at the surgery.
I’m sorry to hear that. All those weeks and it’s still being attended; I’m beginning to realise there’s probably a much longer road ahead than I’d anticipated. I’ll ask tomorrow when it’s dressed again. I’m very undecided about Apixabin. It seems to be at the root of a number of changes and problems in recent months and I’ve only been taking it a year. I hope your wound heals soon.
Is it leaking? My daughter says the dressing shouldn't be changed too often but should be done when the leakage reaches 2/3 of the area of the dressing or after 7 days at the latest.
Yes, it hasn’t stopped leaking gook and goo. There’s no sign of it drying or healing and it’s definitely infected. They took a swab Tuesday and result may be ready tomorrow. The dressing is soaked and changed every 3 days. I’m taking 500mg of flucoxacilin 4 times a day, so hoping a hefty dose will get the infection sorted. I still can’t get my head round something apparently trivial turning into this nightmare.
I have been taking Apixaban now for 5 years or more. This is the first problem I’ve had. The wound viability nurses have been advising nurses that are caring for me having seen photographs of the wound. It is still leaking but improving. So I’m hopefully on the mend. Hope you feel better very soon.x
I gashed my leg a few years ago. I was concerned it was slow to heel so went to the GP who said no need to worry. But then I went back a few weeks later as there had been no improvement and saw the pracice nurse who said I did need to worry being on steroids and they dressed it regularly for me and monitored it. It did heal eventually but I'm left with a load of scar tissue. I also looked into having a cosmetic operation a few years ago and was turned down because the surgeon said the wound wouldn't heal being on high steroids.
That’s tough. Healthcare is such a lottery and it’s grim getting conflicting advice. One expects to trust a GP. Satan’s little helper pills really are the gift that keep on giving😱. Our dog injured his spine 3 weeks ago. Vet wanted an MRI (£2000) followed by surgery ( around £10k) but at a specialist centre over 100 miles away. I asked about alternative and he said steroids may work just as well…but it was unlikely they’d be able to operate after steroid treatment because of healing issues. He started on 15mg a day and is improving, I’m pleased to say. He’s tapering now , currently at 5mg but is fully mobile and wanting to run.
Feel a lot of sympathy as I had a similar gash and am also on Apixaban. I also agree with the sense that Apixaban creates more problems than it solves! I do now go straight to the nurses at my practice (I know them well 😂)and let them keep an eye on the wound. It takes ages for them to heal. You’ll get there! 👍xx
Thanks Thelmarina. I’ll be straight off to practice nurse if I have future injury that’s for sure! It was dressed yesterday and it’s improving. Infection seems to be settling and the nurse said there’s new skin beginning to form at edge. She was pleased with progress and I’m hopeful it’ll stay on track. I’ll be a patient patient!🤗
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