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Thread: Please help, Major Ankle Pressure Wound Question

  1. #1

    Please help, Major Ankle Pressure Wound Question

    I broke my lower leg, fibia and tibia, three weeks ago (long story as to how), and the ortho put me in a hardshell boot with air-filled, inflatable balloons inside. I blew the balloon up too tight and now have major pressure wounds on each side of my ankle and edge of heel.

    The sore on one side of my ankle, the medial, is about 2 inches in diameter, and is increasingly blistering and very puffy. It looks just awful, and like it is very tender and about to open.

    A home health nurse came and put a pad on it and then wrapped my ankle up with the self-sticking bandage stuff... "for compression and increased blood flow." She then said to elevate it and apply ice packs to the surrounding swollen area. She said it should heal in about two weeks.

    I made her call another home health nurse with wound care experience, but did not get much info. I then politely, yet assertively, argued that I didn't think such a nasty wound should be touched/pressed on at all with a bandage, as in "no pressure, no compression." But I relented to the professional.

    What's the protocol here?

    What's the best course to make sure the providers I see are competent regarding this sort of very delicate injury? Do I need to insist on seeing a wound care specialist.

  2. #2
    Sorry that I can't offer any advice beyond TRUST YOUR INSTINCTS, spaceboy, which in this case sounds like aggressively pushing for a visit with a wound care specialist. The last thing you need on top of the tib and fib break and existing wounds are complications caused by an uneducated health care provider.

    Sending healing vibes and support.

    --THC

  3. #3
    Senior Member lynnifer's Avatar
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    The sticky wrap is called Coban. It's definitely what led to major healing for me and I've had chronic foot problems since age 17.

    With the foot, it can't be swollen AT ALL. The Coban keeps this from happening .. but watch the top of your foot where it connects to the leg. There's also a bone there and if wrapped too tightly, it starts to 'cut' into the skin. They should have wrapped you right up to the knee? Hopefully they put a cling wrap or sometimes a cotton wrap is used underneath the Coban.

    I imagine the 'structure' of your leg has changed with the breakage ... you might have some challenges with wounds from now on with how you sit and how the foot sits on the footrest ... hopefully not, but it's something to watch for.

    How long were the 'balloons' in this cast too tight, before you noticed?

    Supplements help too ... iron, zinc, a multivitamin in addition.

    Keep your feet up higher than your heart if you can ... the faster you get those healed, the less chance you have of osteomyelitis hitting the bones that are soooo close to the skin there. Then you're in a mess of problems. Just wanted to warn you!

    The Coban should come off in two or three days ... when's your next planned visit? They'll probably re-evaluate and re-wrap you 3x's per week ... just a guess.

    Another trick I used was ABD (abdominal pads - sterile 5x9) for cushioning ... they're cheap and it worked rather well in my opinion!
    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

  4. #4
    Hi,

    If you have a new open wound on your ankle from the boots, I would not recommend you put the boots back on, and inform your orthopedist of this. Maybe there is an alternative immobilization technique at last until the sore heals. It probably depends on if you walk or not.

    As far as applying a compression type like Coban, I also would not recommend this until you see how the sore progresses. If it is red and swollen, I would recommend a dressing that can be easily removed (such as normal saline wet to dry) so you can observe this at least twice daily. Keep it clean and elevate your legs above your heart for the swelling. Keep all other pressure off. If you develop fever, purulent drainage, you should also contact your doctor. As far as healing, you have not given specifics but these wounds usually take longer than 2 weeks to heal.

    Re how to tell if personnel are knowledgable on wound care, if it is a straightforward skin issue, you may be Ok but if it is anything at all complicated (such as a leg fracture complicated by a wound with swelling), I would ask for a wound care specialist. Hope this helps.

    AAD

  5. #5
    Senior Member Mona~on~wheels's Avatar
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    You have alot of different issues going on.
    I think you need a wound care specialist to make sure you're healing.
    Best of luck. Take care.

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