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wound that won't heal

In June, my husband was trimming hedges.  About 3 days later he had a "sore" spot on his leg. (He is diabetic).  It appeared to be a small sore that had a raised scab on it.  It was painful to the touch.  I put neosporin and a bandaid on it over nite.  The next morning it had bled and when I removed the bandaid, something that appeared to be a small stick (size of the end of a pencil lead and about 1/2 inch long) came out and created a hole in hole.  Over the next week, the hole became bigger and bigger.  It was about the size of 50 cent piece when he went to the doctor.  He thought he had been bitten by a spider and maybe the "twig" was the stinger.   After two weeks the doctor decided to remove the necrosed area (now silver dollar size) and about 1/8 inch deep.  After several weeks of trying to get it to heal as it drained yellow thick drainage, they opted for a skin graft.   A clean split thickness skin graft cut about 4 inches long of tissue was removed from thigh and grafted to this area on his shin.  Weeks went by before the skin graft itself decided to take but in the meantime the donor site which had almost closed and seemed healed began to open up.  It has "grown" to 3 or 4 inches wide and at least 4 inches long of "hamburger" looking flesh.  Each pore seems to have opened up to a crater and it bleeds every day.  It had a odor for a couple of weeks just recently but that has gone away.  We go to the wound care clinic weekly and change the dressing daily.  the site where the graft was placed has finally healed over, but where the suture was placed (there were 4 placed around the site to hold the pressure dressing in place but only the top one nearest the knee has eroded) started after eight to ten weeks with a "blood blister" appearance about the size of a pencil eraser.  that area has now gotten the same "hambuger" growing appearance and is now size of quarter.  
We have had four different surgeon, wound care specialists see him at the wound care clinic, his family doctor and the cardiac doctor have all looked at these two areas and all have said "we've never seen anything like this before, don't understand why it is doing it or what is causing it to do it"  This has been going on since June, surgery was in July 7th and we are about at our wits end.  
Couple of side notes:  Besides diabetic, he was found to have Atrial Flutter on the pre-op testing in July.  The week after surgery the cardiologist put him on Coumadin.  As his PT, INR was rising, we thought this may have been causing the bleeding, but he had the necrosis beginning before the surgery in the original site.  He has gotten so frustrated with the meds he is on, he stopped taking everything except his insulin two weeks ago, but the leg is still not healing.  
Any suggestions as to what is causing this tissue erosion, non healing?  At this point, any new ideas would be great!
2 Responses
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351246 tn?1379682132
MEDICAL PROFESSIONAL
Hi
Welcome to the MedHelp forum!
From the post it is not clear so I am suggesting you get a culture sensitivity of the discharge or scarping from the wound. There has been an odor so there is every chance that the wound is infected. Once the causative organism is identified and its sensitivity to an antibiotic tested, it can be given both locally and as injectables.
The blood sugar needs to be strictly under control. Other problems like hypothyroidism and peripheral artery disease should be ruled out.
At times placenta extracts help in wound healing. These should be tried.
Hope this helps. Do discuss this with your doctor. Please let me know if there is any thing else and do keep me posted. Take care!
Helpful - 0
144586 tn?1284666164
The best, and perhaps only, treatment is not available in the United States. That treatment is phage therapy, available only at Tbilisi at the Eliavi Institute. Phages have been used in Russia for the last hundred years. Watson, who recieved the Nobel prize for his work with DNA started off researching phages. I had the privilige some years ago of spenting a half hour with him while he extolled the virtues of phage treatment for infections of the sort you describe. Low-dose nicotine is also helpful, although the treatment is somewhat controversial.
Helpful - 0
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