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Small cut/wound that will not heal combined with fungal/yeast infection

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    #1

    Small cut/wound that will not heal combined with fungal/yeast infection

    So this might be kind of a long description, but I want to make sure I run through everything what is going on.
    I'm C5, lose feeling from my midchest down, take OxyContin, baclofen, Klonopin, Ditropan, Senna


    The last week of June we found a small cut right where my left butt cheek meets the back of my thigh. It's tucked into the little crevice. About three quarters of an inch long, clean-cut? Maybe somebody got me with a fingernail or it tore due to friction. Not quite sure but definitely not due to pressure. Anyway so here's a list of things we tried on the cut and what they've caused
    -June 20-Tegaderm-essentially was helping the cut get better and preventing friction-doing okay
    -July 10-Dr. switched me to Vaseline with a small Telfa pad taped on-still doing okay
    -August 1- cut is now very small but a little yellow in the middle and not quite healing as fast-Dr. wants to get rid of that yellow skin and has me switch to a layer of wet gauze to get rid of yellow skin, with a layer of dry gauze on top-doing okay for the most part but skin and around the area is starting to deteriorate a little due to moisture and tape
    **also at this point I started 7 days of Levaquin for a bladder infection
    -August 22-wound is still not healing and area around it is deteriorating, Dr. switches me to triad wound cream with nothing covering it
    -August 26-wound is getting a little bigger now and area around it very red, superficial skin breakage, I don't think my body like the zinc oxide in the triad. Stopped triad and she just had me coat it with Vaseline and leave it uncovered
    **Also finding large spots of moisture on the bottom of my pants- about the size of a pancake-I just thought it was from the Vaseline -toward the front of my bottom-cannot figure out where the liquid is coming from, not bladder or bowel and wounds are not seeping enough to produce that.
    -September 4-actual original wound is about the same,. Below it on the back of my thigh is very red, and now my scrotum is incredibly red, had me leave the wound uncovered still and started sprinkling on Zeasorb (Mikalog) all over my rear and my scrotum. Essentially thinks I have a massive fungal infection also wants the powder to keep it dry-still getting the big wet spots
    -September 11-original cut still shrinking, rest of the area looking a bit better, scrotum still really red. Has me continue the powder, has me take one single dose of Diflucan (thinks I have a yeast infection in my groin). Also has me start using ketoconazole body wash.


    Sorry that was so long but, figured I would get all the details in and save people from asking me questions about things I've already tried. So basically now I have the very small original cut which is healing slowly I think, a large red area on my thigh which is getting pinker and less red, and my scrotum is still getting less red as well.


    But, not happening very fast and still getting all that moisture? I'm fairly certain it's from my groin area, can yeast infections cause liquid like that? Trying to keep the area dry and I can't figure out where the liquid is coming from. I have a suprapubic catheter, and I'm not leaking urine. Thing is, that liquid is not exactly helping things heal well. I've looked for cysts and other things that could cause, but nothing. It appears to be clear as well? No color to it.


    **Also, I do not sweat. Typically there is a bit of moisture there warm and some condensation, but really very little, not enough to even leave the spot on my pants.


    Anyway, looking for suggestions, anything you guys might think of. This really should of been healed by now and the redness on my scrotum/thigh are not going away fast. It's actually got me really depressed.
    Thank you all, let me know what you think
    Tags: None
    #2
    Any way you can post good quality close up photos here, or send to the SCI-Nurses' e-mail account?

    (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.

    Comment

      #3
      Exact same experience. heals only after much care, monitoring, and time.

      Comment

        #4
        Does Vaseline actually have healing properties? Or just to moisturize the wound or act as a barrier?

        Comment

          #5
          Vaseline does not have healing properties. It acts as a barrier.
          Without seeing the wound, it is difficult to say what it should be doing. The area around it is probably from the wound draining some as is the scrotum region.
          This is a challenging area to clear up because of the dampness and the folds of the cheeks covering it. Are you staying of the area? And I mean totally off of the area? That may help to spead things up.
          ckf
          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.

          Comment

            #6
            Just finished up with the exact same issue. Looked like a paper cut in the "gluteal crease". I put soap on my shower chair to slide on to it and I think it might have dried out the area. Not having the sling all the way under my butt cheek could have stretched it until it separated. It was like this for a year. Didn't get better and didn't get worse. Wound Dr. had me putting a a saline soaked piece of Promogran in it and keeping it covered. After getting a softer cushion for my Raz chair, making sure the sling was way under my butt and using Manuka honey with a hydrocellular foam dressing and drinking a high protein drink each day it finally closed up two weeks ago and is gone. Not sure which part of the equation was the answer but I'm glad it is gone.
            "Never argue with an idiot; they'll drag you down to their level and other people may not be able to tell the difference."

            Comment

              #7
              Originally posted by 24/7 Quad View Post
              Just finished up with the exact same issue. Looked like a paper cut in the "gluteal crease". I put soap on my shower chair to slide on to it and I think it might have dried out the area. Not having the sling all the way under my butt cheek could have stretched it until it separated. It was like this for a year. Didn't get better and didn't get worse. Wound Dr. had me putting a a saline soaked piece of Promogran in it and keeping it covered. After getting a softer cushion for my Raz chair, making sure the sling was way under my butt and using Manuka honey with a hydrocellular foam dressing and drinking a high protein drink each day it finally closed up two weeks ago and is gone. Not sure which part of the equation was the answer but I'm glad it is gone.
              What form of the honey did you use capsules?

              Comment

                #8
                The paste in a tube from CVS.
                "Never argue with an idiot; they'll drag you down to their level and other people may not be able to tell the difference."

                Comment

                  #9
                  Pictures will be emailed in a matter of moments. Didn't want to post pictures of my undercarriage to the message board.

                  Comment

                    #10
                    Originally posted by SCI-Nurse View Post
                    Any way you can post good quality close up photos here, or send to the SCI-Nurses' e-mail account?

                    (KLD)
                    Pictures will be emailed in a matter of moments. Didn't want to post pictures of my undercarriage to the message board.

                    Comment

                      #11
                      Originally posted by SCI-Nurse View Post
                      Any way you can post good quality close up photos here, or send to the SCI-Nurses' e-mail account?

                      (KLD)
                      Probably a stupid question… But I tried sending a message via the SCI nurses email and I could not figure out how to attach a picture… Please advise

                      Comment

                        #12
                        No message received. Did you follow these instructions?

                        http:///forum/showthread.php?51479-P...the-SCI-Nurses

                        You would need to add the photos as an attachment to the e-mail.

                        (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.

                        Comment

                          #13
                          Originally posted by SCI-Nurse View Post
                          No message received. Did you follow these instructions?

                          https://www.carecure.net/forum/showt...the-SCI-Nurses

                          You would need to add the photos as an attachment to the e-mail.


                          (KLD)
                          Oh, I understand now. Sorry about that, I just sent the message to the Hotmail address now. Thanks again

                          Comment

                            #14
                            Thanks. Got the photos. I think you have a combination of issues going on. #1 is a skin tear over your ischium which is probably also a pressure injury. How deep is that slit? It is easy for a sinus tract to form in that area if you sit on a superficial wound, and that could the the source of the drainage. #2 is maceration of the skin from being kept moist in the area around that wound, and also in your groin and peri-scrotal area. #3 is a skin yeast infection, which is added to by this maceration above.

                            Washing the areas involved daily with a mild antibacterial soap is a good idea, but you have to be sure that the skin is well dried. Get all the residual antifungal powder off at that time. Pat dry with a towel (don't rub). Allow to air dry. A good way to do this is to lay on your back in bed without any lower clothing, and put your legs into a frog position. Try to maintain this position for at least 1/2 hour. Some people use a COOL hand held hair dryer but even on cool you must be sure that you don't burn the skin.

                            Once your skin has dried well, then apply a very thin dusting of antifungal powder. Don't cake it on. Brush off any excess with your hands.

                            Even with a SCI, you can still sweat due to environmental heat in your skin folds, and the groin and scrotum are prime areas for this in men with SCI. Once your fungal condition is under control, you may want to consider using a piece of folded Interdry ( https://www.interdry.com/ ), which is a wicking, silver impregnated fabric between your skin folds. Also, continue to do the washing and frogging as above preventively at least daily (ideally twice daily).

                            Avoid sitting on the ischial area until it is fully healed. If it continues to leak fluid, ask your physician to refer you to a wound care specialist to determine if you have indeed developed a sinus tract there, and for more appropriate treatment.

                            (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.

                            Comment

                              #15
                              I've used Duoderm in the past successfully. In addition to helping the wound heal, it also provides a cushion. I found that it seems to make the wound larger initially. Maybe because it's removing the dead tissue. It also seems to increase the healing time if left on all the time. Hence, I leave the wound open when possible. Once the wound starts closing up, I may use gauze instead of Duoderm (speed up the healing).

                              I've also applied TENS or EMS to increase blood flow.

                              Just my experience. No expert here.
                              Last edited by August West; 16 Sep 2019, 4:32 AM.

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