Treating open sores on lower legs. Any advice?

Just read your reply to NancyIS. Great that Moms legs are looking better and you have WC.

My father use to always have leaking legs from edema. His doctor put a type of Zinc Wrap that he wore for 5 days. Then seen the Dr. He peeled it off and the wounds were 75% healed. So the Dr. wrapped them again for 5 days and they were completely healed over.

My mom is 82 & has extreme RA. Several months ago she developed a sore on her ankle.... it has progressed & are seeing a WC doctor. Today she sees a vascular surgeon after a CAT scan. The sore has been debreved & used a honey ointment .. didn't work now using collagen. Hopefully we get some answers today. Definitely see a WC doctor, don't treat it on your own.

New Zealand Manuka honey

Yes, you are doing what you can, but you need to take her to see her doctor, let the doctor know about her refusal to wear compression stockings and discuss treatments with her doctor. Is she bed-bound? Does she need to be turned every few hours? Ask if it is time to get her a hospital bed (Medicare/Medicaid will provide one), and there are medical grade "mattresses" (they lay over her mattress) that give gentle massages to enhance circulation, also ones that go over legs.

Please take her to her primary care doctor to have her legs evaluated and treated. Follow her doctor's plan of care for her legs: antibiotic ointment, clean bandages, and compression stockings.

I would definitely have her see a dr who will do a Doppler on her legs. My dad had swelling on his right ankle for years and the dr kept telling him it was arthritis but when he had his heart attack after years of his pcp telling him it was arthritis we found out he had a blood clot in it. Which they believe caused his heart attack. Then when he fell in mr last year and got two brain bleeds and spent a month in the hospital then in June he had his first tia they found 2 blood clots. My sister took him for his follow up to the va and we had no idea he had developed a soar on the back of his leg around where the blood clots were. His left ankle had started swelling also. When he was in rehab they kept putting antibiotic cream and bandages on it but the soar just got worse after he came home and eventually he just couldn’t walk anymore and he was totally wheelchair bound within two months of the fall. Then in August we were told from the va that he needed long term care. He ended up in the hospital the next day and then to rehab again and the soar was really bad they had wound care come and do debreving I had no idea what it was until I looked it up and omg it had to be the most painful thing he ever endured and believe me he had been hurt bad a few times. Since he was on medicare he was getting to the end of his days to be in rehab so we had to decide what to do. He could have stayed in rehab because he also had blue cross and blue shield but we knew he was going to long term care and we were having to put him on hospice and with the treatment being so painful we stopped it. Eventually even with everything they did for it he ended up with grain green and since he had a living will and poa they couldn’t do anything plus I don’t think he would have survived any type of surgery. I would also like to add he did not have diabetes. I really believe it was a circulation issue. You should be able to get some type of wound care to come to the house through medicare. Her dr would have to set it up. I would just hate to see her end up like my dad and go through what he went through. I wish you the best.

Msblcb: Your mother needs to see a vascular doctor who should be able to assist with all of her issues, e.g. compression stockings ordered by a third party company, the edema and the wound care need. Of note is that sometimes compression stockings do not eliminate the edema. I had obtained the compression stockings ordered by my vascular specialist, wore them for twelve hours and my edema was even worse. When I spoke to my specialist about the issue, he said "sometimes they do not work."

Definitely see a vascular surgeon, and also a wound care specialist. You didn't mention if she was diabetic. My Dad is diabetic, and almost lost his leg. Fortunately, he only had toe amputated. There IS one thing I know that helped him - drinking JUVEN (powder mixed w/water) for healing wounds. It was amazing how the wounds really started to heal. Anything takes time with these things, but his did heal. You have to be careful w/open wounds because of infection. I hope you are taking her to see a medical professional soon. Good luck!

Hyperbaric oxygen therapy, if there's a center in your area. Ask her doctor to see if he can refer and get the appt. paid for by insurance.

She should see a vascular surgeon for blood flow testing. The lady that I had taken care of had blockages in both legs. It can be caused from age and narrowing of arteries (atherosclerosis), as well as life style (she smoked for 50 years). She had to get iliac artery stents put in both sides of the abdomen. They go through the thigh. It is a fairly common procedure. It helps restore blood flow to the legs which help heal the open wounds. If they can not unblock the arteries enough, the wounds will have to be cared for indefinitely and often daily to prevent cellulitis. When cellulitis happens a bacterial infection could easily occur. This was her situation. There are some good products available for wound care and dressings that are padded-which help a lot to prevent re-injuring. Depending on her insurance, they may cover the topical medication and bandages. The doctor can prescribe a wound care person to come (many insurance plans cover this). They can tell you what the best products are for her particular needs and care. Definitely stay on top of it. My lady had to have her little toe removed because it would not heal and gangrene set in. This is just one scenario. Sometimes the body can create their own blood vessels, called angiogenesis over time, which can help with blood flow. Regular massage might be helpful too. All the best in her continued recovery.

Perhaps a vascular surgeon could discuss this issue and other options with you and your mom: knowing what can happen if there isn't cooperation, may give mom some insights into her future.

All great treatment advice. One is missing: Cellulose Gel instead of the antibiotic such as Bacitracin or Mupirocin. Learned from Wound Care. After MONTHS of trying antibiotic cream and bandages, the Cellulose Gel cleared them right up. Made sense, our bodies use Cellulose to repair the cells/skin. Also ask your WC Dr for referral to Lymphedema Therapy. We couldn't keep the swelling down either. Sometimes a sore would open and just ooze water for days. The therapist will teach you to do Lymphatic Massage which moves the water up and out. Gosh, 2 hrs after 1st massage, her bladder was really in overdrive. The therapist, because of veinous insufficiency, got her the Compression Boot mentioned in other recs for both legs. Works GREAT! Available thru Tactile Medical. Also, since the comp hose was a no go (and actually caused more sores) the therapist got approval for Velcro Compression Straps. Easier to put on and adjust, more comfortable to wear, and, unlike hose, can be worn while sleeping. The straps are called CircAid Kits. Look them up. By using all 3, we no longer have the swollen leg issues and NO SORES!! Wish you and mom the best!!

Nurse Mates has some really cute compression. I think a lot of folks get the idea of 'old folk' compression socks that are either just white or black. I have some very funky ones, some with pigs flying, some with paw prints, some tye dyed. (Believe it or not, hubby will wear the tye dyed ones out in public with shorts, as he broke his leg and needs them, too). I've found that for me, the thinner ones work just as good as the thick bulky ones.
Good luck!

I see a lot of posts that recommend different "toppings" If the wound is open, consider that certain products may not be sterile. Best to see a wound specialist. Yes there are many people who cannot tolerate compression stockings. Remember to tell to the doctor for other possible options.

If the source of the edema is venous insufficiency, she might be a candidate for an outpatient, minimally invasive procedure called venous ablation. It's done through a long intravenous catheter with local anesthesia (lidocaine injection) at the catheter insertion site. The doctor injects dye first to see if the procedure will be effective before proceeding. When effective, the edema is reduced or eliminated, causing the ulcers to heal much more rapidly and (hopefully) not return. A vascular surgeon is the one who does it.

Another option, if you can afford it or if Medicare will pay for it, is a sequential compression device. Your mom might be more open to that because she would use it intermittently, not constantly like compression hose. She might have used one before if she has been in the hospital. It's a boot shaped garment she would put on while lying down or while seated with her feet elevated. The garment is connected to a shoebox size device that inflates the garment, starting at the toes and going up. After a few minutes it deflates, then repeats the cycle. My dad likes his, says it's like a massage.

A wound care specialist doctor is essential, so glad you have that! She can tell you more about these options and others. Good luck!

We dealt with this, as well. My mother was still living on her own, two states away, at the time. She chose to ignore the issue until the wounds were very advanced. I found out about it only when she landed in the ER. This is a serious medical issue and, as others here will undoubtedly tell you, it requires the attention of a specialized wound care team. As averse as your mom is to compression stockings, etc., she is going to like it a whole lot less if she has suppurating, painful sores and possibly septicemia. Good luck. I know how difficult reasoning with a stubborn mother is!

Manuka Honey - also works on bedsores.

my 91 yr old mother is going thru the same exact thing and initially her PCP thought it was cellulitis and put her on 14 days on 3x per day antibiotics(eventhough i kept telling her cant we just do 7 days - now her kidney function plummetted and her blood thinner is making blood too thin).....eventually i took her to wound care and they dont think its cellulitis but venous insufficiency and they put an unno boot on - its medicated wrap(wrapped tightly) - she couldnt tolerate it so we took it off which dr said was ok - we alternative between using benodyne and silver sulfiazide EOD and intiially cleaning wound with dial antibacterial soap.....also, we got non adhesive stick pads so everytime i cleaned wound and took gauze it didnt rip what was healing - this is all under advice of vascular/wound care dr...mom is also diabetic and so its taking longer to heal but yesterday wound care dr said "its healing but will still take tim".....then we got her flu shot and she is sick as a dog - like when she got covid shot last month - i cant believe they say take both at once - my mom would be dead! good luck! Change the dressing daily..mom cant tolerate compression either - ask your mom to elevate - that helps circulation and healing if compression not tolerated.

have her fitted for compression hosiery at a home helth care store. They are much easier to get on and feel better.

Try putting sugar on the sores and light bandages. It works with diabetics and nursing homes.

If I read right , she’s in AL, wound care has been ordered.

my mom had it , they kept wrapping her leg for compression, after dressing it. It did not heal until the compression stockings were used. My mom had edema , refused to elevate her legs even with a recliner .🤷 try what GA in PA suggested…

Dampen a gauze bandage lightly with water add goldenseal powder to it apply to wounds and wrap. Will stop infection and dry the wound up.

Please check out online all the different types of compression socks. The traditional ones are SO difficult to get on and if the person is uncooperative, it can be a 45 minute struggle(!) Hopefully there are newer versions that will be appropriate. Best wishes & a hug 🤗

Thank you for your advice. I did speak to the RN today at the ALF. They have bandaged the wound and the doctor is ordering Wound Care. I appreciate the guidance so much.

Go to the doctor and she will be assessed for medication, compression hosiery and possibly the need for a wound care nurse. Those sore can fully develop into vascular ulcers. More difficult and time consuming to treat. I had on that took months to heal. Mulltie weekly visits to wound care clinic and barometric chamber treatments. Don’t mess around with this condition.

From what I read Mom needs to wear compression socks. If she does not like the full foot ones, there are ones with the toes out and heels. There are ones that only go to the ankles.

"In general, venous insufficiency does not pose a serious health threat; however, it can become disabling and cause pain as the condition worsens. In addition, if allowed to continue untreated, chronic venous insufficiency (CVI) can lead to skin changes, skin ulcers, and infections.Jul 16, 2021"

From what I got out of the above it needs to be treated to keep from getting the sores. Keeping the leg moisturized like you are doing is good. But if these sores do not heal what I read said septis can set in. She needs to see a Phlebologist if this is a vein thing.

She can become septic so I would get her to a doctor ASAP. If not a dictor an ER. Does Mom have diabetes or CHF?

My mother had that happen when she had edema in her leg. They need to be treated by wound care care. Compression bandages and special medicated wrapping healed it. Don’t wait, the skin can degrade very quickly.

I would as to be referred to a wound care specialist asap.

https://www.webmd.com/skin-problems-and-treatments/venous-skin-ulcer

She may need antibiotics, and special compression bandages might be recommended.