Daughter has an unhealed wound after a month

Hi :) My daugher age 13 has a wound on her foot that has been unhealed after over a month. It will look like it is healing, even get smaller, but then open up again and look all angry and nasty. We have used bacitracin on it and neosporin as well as Bandaids on and off to keep it from getting too moist, but it doesn't seem to help any more. I should go into some background though... the wound is directly on an old incision scar, where she has had multiple surgeries the last of which was a little over 4 years ago. She has a very aggressive (benign - well as of about 4 years ago it was :) ) tumor in the bone directly below the incision site, and until very recently had been healing, but now has gone dormant- not growing or healing. She has had the tumor for 10 years, and is inoperable as it has surrounded all the major tendons arteries and such of her foot, so it has been left there and different fairly aggressive treatments have been tried over the years. Most recent of which was alcohol sclerotherapy, and though I cannot be 100% sure exactly where the injection was placed, I am fairly certain it was very close to this wound, although the last injection was over 2 years ago, and there hasn't been any indication of problems since then until now. (She has had probably 10 total injections over 2 separate courses one about 7 years ago, the other about 2 and a half) She has also undergone chemotherapy with Interferon almost 2 years ago (which also did not affect the tumor). She does have Von Willebrands, and has been taking Stimate for about 10 years for bleeding issues, but this wound doesn't bleed excessively though. The foot itself is rather warm, and swollen, but she has gone through so much back and forth with swelling and temperature due to the high blood volume in the tumor (it is a hybrid of an Arterial Vascular Malformation and a Lymphangioma) so I am not sure if it is regular tumor process, or something more worrisome. Her pediatrician said we need to talk to her surgeon, and though we have called and left a message with him, I feel like I am being an alarmist in a way... should we talk to a wound specialist? (Her orthopedic surgeon is an Oncologist dealing with bone and blood cancers)  Any other suggestions??? Sorry for the lengthiness of this!!!!!

[Bhupinder Kaur, MD]

Hello,
Your daughter’s pediatrician is right in suggesting that you should consult her surgeon( an orthopedic surgeon with an oncology background) and it will be the best. It is very rare for a wound to be persistent for such a long time unless or until it is complicated by other factors and in this case the coexistant tumor which she has may be one of the causes.

So please get an examination done and a bacterial/ fungal culture of the wound swab done.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Bhupinder Kaur, MD]

Hello,
Your daughter’s pediatrician is right in suggesting that you should consult her surgeon( an orthopedic surgeon with an oncology background) and it will be the best. It is very rare for a wound to be persistent for such a long time unless or until it is complicated by other factors and in this case the coexistant tumor which she has may be one of the causes.

So please get an examination done and a bacterial/ fungal culture of the wound swab done.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.