HELP! Severe infection in leg, WARNING photo included.

[beautyguru]

Can anyone help please? My friends dad is elderly & in hospital at the mo. He has various illnesses including diabetes, COPD & takes warfarin daily. He was admitted because of cellulitis in his leg but it just isn't getting any better & no one in the hospital is giving her answers or have said they know what's wrong with it. Also his sodium levels have increased so he is now on restricted fluids. My friend is panicking about him so hoping someone here might have a suggestion as to what's wrong with his leg as it doesn't just look like cellulitis any more. Thanks in advance.

My dad has been through this too.

It took around a year of compression bandaging to get healed but the skin is very delicate now.

There is likely to be underlying reason for it. Diabetes?

Who took this photo.

He has leg ulcers because of poor circulation, either venous or arterial, or a mixture of both. The diabetes is exacerbating the condition and also means that compression bandaging is contraindicated.
Has he been referred to the Tissue Viability Specialist (usually a senior nurse post) and/or Dermatology Consultant, and probably would benefit from Vascular Surgeon opinion.

Diabetes means he has trouble fighting infection, COPD means a lack of oxygen and the warfarin means his clotting ability is conpromised.

The sores won't scab leaving him open to re-infection, the lack of oxygen and the diabetes means he can't fight off the bugs.

There are a number of causes for hypernatraemia, all of which may be directly linked to the infection, the diabetes or something prescribed.

en.m.wikipedia.org/wiki/Hypernatremia

My friend took this photo, why do you ask Retired?
Yes he has got diabetes MissWD, did your Dad have medication to help it heal? & did it get worse before it got better?

Cellulitis can end up with ulceration, and sadly the diabetes won't help that get better very quickly. Is he very careful with his diet? It can take a very very long time to heal even in a healthy person, my mum isn't diabetic but had cellulitis after an infected insect bite and her legs took well over 12 weeks to heal and many courses of antibiotics. I hope he's on the mend soon.

It doesn't look like cellulitis now. Looks like leg ulcers to me and will take a long time to heal. Did your friends dad consent you to putting a pic on here? Probably need tissue viability nurse input if staying in hospital a while for advice. Having diabetes will make it take longer to heal too.

It looks like venous leg ulcers to me, they don't look like ischaemic ulcers to me.
Unfortunately they are very difficult to get rid of with diabetes and warfarin and people can have them for years especially if not very mobile.
They need to have specialist treatment and can only have compression bandaging if their ABPI (indicator of arterial supply) is ok.
During the healing process care must be taken that they do not get infected and if they do like most long term ulcers do he may need intravenous treatment in hospital.
You can lose sodium through leg ulcers as they weep a lot and also become vitamin deficient so it's important to get a blood test regularly.
It will depend on his general health and blood sugar levels as to how quickly they heal but to be honest it is not going to be quick, even in non diabetics that type of ulcer is very slow healing.
I wouldn't panic too much people can and do live with these types of ulcers for years.
I deal with ulcers in my podiatry clinic and the local hospital.

My friend sent me the pic to try & get some help by sharing online as it's not something that can be explained. There are no identifying features on the photo that I can see, so no way of identifying who he is so I'm confused why I'm being asked?
Il pass all the above info onto my friend. Shes not great with technology & didn't know where to start looking hence me doing it for her.
As far as I know he hasn't been referred to the tissue viability specialist as yet.

Thank you for all your posts, lots of good information for her (& him) and hopefully will help put their minds at rest as they are obviously very worried, especially when they aren't getting any answers off the hospital.

It's more I suppose that I wouldn't fancy my leg being put on the internet without being asked, even without identifying factors. Has he got low sodium rather than high? You are more likely to have hyponatremia than high. That's why he would be on fluid restriction.
They will be kept a close eye on and when discharged either district nurse or practice nurse will dress his leg and asess regularly. Unfortunately it is a long and slow process. It's important to eat well to aid healing that way too. Hope it gets sorted.

My DH is currently being treated for a venous leg ulcer - only one major one although that's because other outbreaks have been spotted and headed off by the superb practice nurses. It's been a long old slog, we've been seen at the practice twice a week for five months - and he is a man in his 40s, not great health but not diabetic/COPD etc. Healing has been much faster since he got into compression, before that nothing seemed to be helping much at all.

I agree, your friend's dad needs to see Tissue Viability / Wound Management specialists, why have the hospital even got him in (esp over a weekend) if they're not pursuing treatment for him?

He's been in hospital now for 2 weeks already 🙁
Re: the photo being on here my friend had no concerns about it, they just what help. Obviously if his face/name/identifying feature was on then I wouldn't have used it but they just really want some help & advice now. I've sent her the link to this thread so she can read it all & show him too 🙂

What is his blood sugar like?

I would drastically cut carbs (not easy on a hospital diet!) and the blood sugar will come down and he will heal faster.

I asked because it looks like he is having a dressing changed so wondered who posted the pic, obviously you would have to have his consent to post it online.