Welcome to the final installment of the series covering the injury, deterioration, treatment, and healing of a laceration to my leg which was affected by Necrobiosis Lipoidica, a degenerative skin condition, causing necrosis of the colagen layer under the skin.
Part Three: The Healing
i was able to go home and have in-home nurses come to change dressings daily, continuing IV antibiotics and dressings with a silver-based antimicrobial ointment. In this treatment plan a silver-based ointment was applied directly onto the surface of the wound (PAINFUL) with either sterile cotton swab or tongue depressor, then covered with gauze sponge (more effective) or nonstick pad (less painful), and then wrapped with gauze bandage. The following day the nurses would use a small amount of saline solution to help loosen the bandages from the wound (they stick to the skin) and repeat the process. Eventually, my wife and I would learn to do this without the aid of a nurse.
In the next two photos are trips to the wound care center to get cleaning, checkups and (in the second photo) debriting.
below is shown after a masonix ultrasonic debriting. After the wound got well enough to do this, this helped remove the slough to reduce the food for bacteria and allow for new growth to take root.
March 12, 2013
March 19, 2013
from here on out we see the skin re-growing…
To accelerate the growth a silicone dressing (Mepitel brand) was placed over the silver-based ointment (Silvasorb) and wrapped with gauze bandages. Mepitel can be reused for about 5 days (at least in my case and under the care of my doctor).
a specialized dressing called X-Cell which is methylcellulose was used. The doctor impregnated the cellulose with a steroid. we found that the mepitel worked better, was easier to get, and was less expensive. my oral prednisone was being tapered by about 2.5 to 5 mg weekly.
April 23, 2013. After six full months, the wound was completely closed up, and i was discharged from the wound care treatment program.