Ulcer still has discharge

[Dunhorse123]

Hi, I've had a digital ulcer since December (2016) which was infected and excruciatingly painful. Doctor gave me 4 courses of flucloxacillin. After 4 months it's much less painful and not throbbing, but it's still leaking pus. I'm not sure if that's part of the healing process still, or if I should see doctor again for more antibiotics? I don't have a temperature. I have to keep it dressed (because of the discharge) and bandaged to avoid banging it. Has anyone else experienced this on-going discharge?

I'd be very grateful for any advice.

[Hidden]

Hi. My advice would be to get it checked again by nurse or GP abs keep going back until the pus clears up entirely. Pus=infection and it probably needs more antibiotics I'm afraid - especially because it isnt getting the opportunity to dry out properly.

I've never had a digital ulcer yet thankfully but I do have a type of eczema which is prone to become infected - currently on my finger tips along with secondary Raynauds. So I know how painful sores at the tip of fingers can be and how long they can take to heal. Sympathies🙄

Twitchy

[bloo]

Hi I've had exactly the same started last August 3 lots of antibiotics and extra iloprost absolute agony. Last November on an iloprost visit (I have 1 infusion every 4 weeks) I had an x ray and was told it was calcinosis. The 'pus' isn't infection it's the calcinosis coming out I've been having it dug out and treated with Manuka honey every 3 weeks since December it's still blumming sore but better than it was I'd mention it next time you go to the GPs

[cowhide in reply to bloo]

I've had the same as Bloo, I have had a weeping ulcer for years which then sort of cleared up when I had flucloxacillin for a different ulcer. As my hands are constantly getting wet and dirty as a farmer it is impossible for me to keep a dressing on, so I do wear gloves most of the time out of doors. I prefer to keep it 'aired' when I am indoors rather than covered over, but have to be really careful not to knock it. It is not hot and red and throbbing - I would go to Dr for more abs if if was - but it never really heals. It gets worse and then some calcinosis comes out - sometimes the toothpaste sort and sometimes a hard lump - and then it nearly gets better and then another calcinosis starts. I put Germolene on it every night to help prevent infection and it also has anaesthetic properties to take the pain away, re-applied during the day if it is getting painful. I really try hard not to let Raynauds take a hold too, getting it warmed as soon as it starts to 'go' as keeping blood circulating to it is so important for healing - as my GP pointed out, if blood is not getting there then neither will abs so keeping that part of the circulatory system 'alive' is very important. I also use hot salty water at times as well. Hope it gets better for you Dunhorse123. .

[tall-tim]

You poor thing - my profound commiserations ! I think I have been where you are now, though thankfully it's not happening any more, thanks to Methotrexate and Sildenafil.

My way of treating the problem was to coax the nastiness up to the surface by immersing the finger in hot salty water. I find out what temperature I can bear for twenty or thirty seconds. After doing this a few times in the day you can see the yellow stuff has definitely welled up and gathered near the surface where you can let it out carefully with a sterilised needle. The prick of the needle is nothing compared to the pain of the finger. The relief is immediate. It's a slow process of getting the stuff out, day after day, until it's cleared. Doctors and other advisors are likely to panic and say "NO - don't do it !!", because you may make the infection worse. Actually, it's a bomb site down there and you need to get the stuff out. That's what is causing the pain. The salt deals with any infection. While this was going on I used sticking plasters (dressing strip cut to size - Tesco is good and cheap) plus topical Bactroban antibiotic ointment prescribed by my doctor; it may have helped stop infection from entering, but was no use in letting the stuff out - in fact I think it blocks the surface layer and preserves the problem.

I have also used the salty water treatment to deal with what looked like a rotting little finger after a burn. (The burn was caused by an acupuncturist's moxibustion.) It was black and I thought I'd lose the end of it, but the salty water treatment dealt with the problem, and the finger is now fine (although it doesn't look the same as it used to). It all took about five months to heal.

As to whether it is pus or calcinosis liquor - suspect it's a bit of both. I've had small lumps of white crystal coming out of my fingers and the salty water treatment definitely helped speed up their exit.

Hope this advice is helpful. It may be worth stating that I have stopped drinking tea and coffee, and that has made a difference to my finger inflammations.

Tim

[Midgebite21]

Exudate from a healing ulcer is perfectly normal. If the pain levels have reduced and it's not throbbing like you've hit it with a hammer all of the time, swollen and smelly chances are it's not infected. I would suggest seeing your practice nurse or nurse specialist (not your GP, they are notoriously bad at wounds!) and ask for a more appropriate dressing eg mepilex or granuflex which are used extensively in diabetic and vascular wound care. They will give your wound a much better healing environment than a simple dry dressing. Also if it does have a low grade infection get actilite dressing and put in contact with wound under mepilex. Actilte is a honey based dressing that has antibacterial properties and as its topical will mean you will not need to take a systemic course of antibiotics. Hope it heals soon. By the way I'm a NHS Podiatrist with systemic sclerosis, I work daily with diabetic and vascular wounds so hopefully know a little about how troublesome they can be! Touch wood I haven't suffered with one for a few years now. Hugs to you

[Dunhorse123 in reply to Midgebite21]

Thanks so much Midgebite, that is really helpful. It really isn't very painful at all now, (unless I bang it), but was excruciating for the first month or so. I do have diabetes as well as limited scleroderma, so this is all very useful and its great to have your professional experience.

Many thanks

[Duttie]

Hello, I have had an infected thumb since Jan 2016 and was told to have it swabbed before more antibiotics. What has been coming out of mine is liquid calcium, so no point in antibiotics. I dress it daily and use clinical grade manuka honey, Activon. I take Sildenafil 50mg three times daily and this has helped to improve the circulation. Hopefully with the warmer weather coming it will heal again as it did last summer. Keep warm.

[kimbalina]

You need ciprofloxacin not flucloxacillin

[Dunhorse123]

Thanks so much for all of your replies and advice. I have noted it all down so can try it out. currently although it is still oozing, the pain is much reduced (unless bang it on something), which is such a relief. I am going to make an appointment to see my practice nurse (as suggested above) and check on the wound care protocol.

On the downside, I've had a lot of problems with hard skin on this finger tip, and I am worried that once it heals (fingers crossed!) it will be likely to break down easily, as there isn't much soft tissue around the finger tip.

Sorry about the gross photo, lol, but that was a huge improvement on when it started, when it was swollen, quite large and full of infection. Yuk!

Thanks again, what a lovely caring community on here.

[kneedtoknow]

Hello: This is [e-mail] and went through something similar. Was misdiagnosed with Raynauds Syndrome, finding out later it was Osteomyelitis, amputation factual. Please get that finger checked for that. I hope your pain will go away. My nib still hurts. Not quite a year since this was taken off. Get well