Warning gross photo! Should I go back to urgent care?

[Doshio]

Left side of photo is one week ago pre-antibiotics. Right side is now, and tomorrow morning is my last dose of antibiotics. When I use a hydrocolloid dressing gunk still comes out into the dressing. Does it still look like I need more antibiotics and should I go back tomorrow morning? GP is closed so it would be the out of hours GP at urgent care. Sorry if this is a dumb question, I don’t want to waste the GPs time and also the other people waiting there. And sorry for the gross photo!

It looks a bit better. How many days have you left the hyrdo dressing on?

That doesn’t look to have healed and you should definitely go back. You don’t give any detail of where it is or how it was caused?

I’d say it looks a little better but doesn’t look healed. Not sure if I’d go tomorrow or wait until Monday. 111 might be worth a call to ask advice

The photo on the left looks like the wound was better then. Is that definitely the one that was a week ago? If so, I would get seen tomorrow.

Oh sorry it is on my wrist and it is a laser tattoo removal that didn’t respond well. I have been having this treatment for about a year and it has never been an issue before this. The hydrocolloid bandage I use twice a day and twice a day I use melolin bandage instead (I use that overnight with medihoney wound gel). Basically I change my bandage when I have my antibiotics, and wash it with wound wash.

Yes left side was one week ago. I have been religiously following the antibiotics schedule with regard to timing and no food etc.

I’d go back - right side looks wetter and less healed than the previous photo.

It hasn't fully healed but it's going in the right direction. I'd say show it to the doctor or nurse, they may say you need more antibiotics but it might just need more time.

Thank you everyone that is a great help x

It’s definitely not healing. Needs more antibiotics of a different kind. Good luck.

DearOP,

Were you told to change the dressings so frequently? It is difficult to ascertain sufficient information from the photos about the site and surrounding area but generally I would leave a hydrocolloid on for at least a day between changes (in the absence of infection I would leave a hydrocolloid dressing on for 2-3 days) and then interfere as little as possible other than gentle cleaning with water/saline. Every time you remove the dressing you can damage healing tissue and also lower the temperature of the wound which means that the environment for healing is not optimal. Is the wound producing a lot of fluid or exudate (pus)?

I understood that you should leave hydrocolloid dressings on until they are ready to fall off. Changing them daily does not give them time to create healing conditions.

You need to leave the hyrdo on. The dressing changes won't be helping. Leave it be for a while.

I got left and right confused. It looks worse now.

Who advised so many dressing changes?

Unless you have a temperature and systemic symptoms no need for urgent care. However, walk-in centre tomorrow. You need new dressings and instructed on how and when to change them. Have you had a wound swab done?

They didn’t give me any instructions whatsoever, he didn’t even bandage it at all when I left last week just left it open and sent me on my way.

Basically last week what happened is I showed up, he asked me to remove the bandage and show him the wound, he prodded it a bit, and then prescribed me antibiotics.

I thought since the bandage became full of pus around the wound site that I should change it so it isn’t sitting in it but I see that is wrong. I honestly didn’t know what was best. I have a hydrocolloid on right now so I will just leave it and have them take it off and look for themselves.

You have to let the hyrdo go kind manky and wet for it to work. Leave it on and the site sealed for a couple of days.

I should have sought MN advice sooner 😥 More helpful than the GP!

In the absence of infection they should be left on for a few days you are correct but when there is an infection you need to change more frequently but not as frequent as the OP is doing. If there really is so much exudate being produced by the wound that the dressings have to be changed that frequently then the dressings should probably be done by a HCP. If it isn’t producing that much fluid then they shouldn’t be changed more frequently than daily. As a previous PP said the OP needs proper instructions for dressing changes by a HCP who has seen the wound in real life.

Thank you I will ask tomorrow when I see the out of hours GP for care instructions. Feeling rather daft for doing the wrong care but appreciate the steering in the right direction.

Agree with what has been said. Worked as a practice nurse for a long time. Hydrocolloid dressings work by adding moisture to the area and due to the nature of the dressing it can appear to look sloughy (pussy) but in fact isn't necessarily infection.
Whilst it looks sore directly on the tattooed area, the part around it doesn't look overly infected. The healing will be taking place underneath the scabbed area, and eventually that will all lift off to reveal nice new pink skin.

What she said ^^ x

If you can't get another appointment, a pharmacist might be able to advise.

If you feel well in yourself I wouldn't bother going to urgent care tonight.

When we are looking at a wound the colour that concerns us us black because that can mean that the tissue is dead or dying however I think in this case the black is either from a poor focus scab or the ink from the tattoo. On the photo on the left there is more yellow slough that has cleared away and the tissue at the top of the wound looks quite red/pink on the right which means things are starting to heal. It's not going to be all that quick of process because the wound is healing from the bottom up unlike a cut which the two sides would meet and heal that way.

I can't really see much signs of spreading redness around the wound, other signs to look out for infection are running a fever, much more pus or smelly or pain at the wound site and swollen.

I'd calm your dressings changes to once every 2-3 days or as required if the dressing isn't holding all the fluid leaking. Theres a growing body of rvidence towards cleaning and dressing and then leaving wounds as much as possible.

I’m thinking to go to the out of hours GP when they open first thing tomorrow. I’ve definitely been going well overboard on the dressing changes (not to mention the hydrocolloid ones are expensive!). Wish I could turn back the clock and have done it properly 😕

I’m well in myself now. Initially (pre-antibiotics) I was developing a slight fever and there was redness and pain around the wound but that has been fine since.

Edited to add, the black is the tattoo ink.