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14 years, first sore, cellulitis, little progress, suggestions?

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    14 years, first sore, cellulitis, little progress, suggestions?

    Last Wednesday I started using Allard ToeOff Afo's. Was doing skin checks. Everything going well until Saturday. Noticed some redness but nothing major. Saturday night the side of my right foot blistered, broke open. I stopped wearing brace. Continued skin check. MONDAY night I went to ER. Very red, swollen up into ankle. They started me on Dynapen. Tues spiked a fever 101.4. Wednesday . Saw my doc. Shot of rocephin continue Dynapen. Blood work showed some inflammation otherwise good. Thurs. Another shot rocefin continue Dynapen. Temp has been back to normal to slightly elevated. I haven't worn breaces at all, but today noticed my other foot looks like it has a red mark and possibly a blister started in same spot as right foot. I go back today to be checked again. Should I expect to see some improvement yet? And why would a second site start when I am on antibiotics already?

    #2
    Cellulitis is unfortunately a fairly common problem in people with SCI...we don't know why. The antibiotic should have prevented the second leg outbreak, but it might not be the right one. Call your provider, or go to the ER. Cellulitis can lead to septicemia, and can cause serious soft tissue damage if untreated.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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      #3
      i was in the hospital for 4 days a few years ago with cellulitus i had iv antibiotics and pills when i came home cant remember what though but that cellulitus had me down fecer leg burning you could feel the heat coming off it and was red and swelled all up
      to alcohol the cause of-and solution to-all of lifes problems [homer simpson]

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        #4
        Saw provider again today. Changing antibiotic to amoxacillion and started IV antibiotics today. Plus sent to wound care for cleaning wrapping etc. Will have both oral and if antibiotics for next 3 days. Hopefully will get some improvement soon.

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          #5
          So infection cleared up. But I am left with bilateral foot wounds that won't heal. The one on the right is .8cm by .6cm the one on the left is .8cm by .8cm. For a month now they have been debrided every other day, cleaned and rewrapped. They just are not healing. I'm doing high protein, supplementing glutamine, and vitamins and continuing healthy diet and exercise. They have used silver nitrate and have now packed the wounds with medicine. Waiting to get into Frodert in Milwaukee for a second opinion. They are talking surgeon and skin grafts. What options are left.

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            #6
            Originally posted by medic1 View Post
            So infection cleared up. But I am left with bilateral foot wounds that won't heal. The one on the right is .8cm by .6cm the one on the left is .8cm by .8cm. For a month now they have been debrided every other day, cleaned and rewrapped. They just are not healing. I'm doing high protein, supplementing glutamine, and vitamins and continuing healthy diet and exercise. They have used silver nitrate and have now packed the wounds with medicine. Waiting to get into Frodert in Milwaukee for a second opinion. They are talking surgeon and skin grafts. What options are left.
            This is a new device for treating diabetic wounds. Since it was just approved it might take awhile to get into clinics.

            https://www.fda.gov/NewsEvents/Newsr.../ucm590784.htm

            or maybe barometric oxygen therapy?

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              #7
              Skin grafts are very old school. They did not work for me at all.

              Have they checked the bone for infection? Cellulitis and fever give it away.
              Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

              T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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                #8
                Originally posted by litespeed4 View Post
                maybe barometric oxygen therapy?
                Hyperbaric oxygen therapy?
                Kills anaerobic things.
                http://zagam.net/

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                  #9
                  No bone infection, they checked. They started as blisters that opened and were very much just on the surface. The one on the right was healing well. Had started at 1.8 cm and closed to .8cm but has stayed there now. Sunday while the right was being debrided the wound nurse said it looks like it may be down to the connective tissue at this point. Still awaiting word from Frodert. This is incredibly frustrating! Edit: I will be seen tomorrow at 2pm in Milwaukee, so hopefully will get some more information.
                  Last edited by medic1; 16 Jan 2018, 11:16 AM.

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                    #10
                    Milwaukee has no answers. I am healthy, young-ish, healthy diet, healthy supplements, appropriate activity, wounds are clean. There is no reason for them not to heal. Except they are not. From my understanding wound vac isn't an option because of the position/location. Skin graft not an option because of high failure rate in ambulatory SCI. Has anyone else had the Integra Flowable Matrix used on wounds? I am trying to find more information as to where I could have this procedure done.

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                      #11
                      Has anyone ruled out compartment syndrome? Compartment syndrome is a condition in which increased pressure within one of the body's compartments results in insufficient blood supply to tissue within that space.The leg or arm are most commonly involved
                      pbr
                      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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                        #12
                        They have not mentioned anything about this. Would it be possible to have it in both feet? As I have a sore on each foot, neither of which is healing. When they have checked pulses and for perfusion/capillary refill its been good. I can bring it up Monday when I go for my next wound care appointment. They are trying again with the poly mem and going to leave it alone for four days before checking it.

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                          #13
                          What’s your red blood cell count? Thyroid? Diabetes?
                          Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

                          T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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                            #14
                            Thyroid good, no diabetes, my esr was initially high but last test showed within normal range. Nutrition great, all labs great. Wounds look great, clean, no infection. No fever, no chills, feel great.

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                              #15
                              I know another incomplete walker with chronic wounds. I hope this gets figured out soon.
                              Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

                              T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

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