Chronic wound after dog attack, 6 months later

[TheBusyMoose]

ok so I need to know if I am being extreme to be so frustrated and annoyed with this situation.

long story short I was attacked by a dog in November and had surgery. It got infected and I had 3 further surgeries a few weeks later. It is now a chronic wound and simply won't heal, I've had 5 more surgeries and I go to the hospital every week and they umm and ahh and say come back next week. I have a hole in my leg, I am in pain and it seems endless. I will post progression photos but it looks worse if anything than when it first happened. I have never been under a doctors care, just see the wound care nurse every week and every so often she will get a doctor and I go back to surgery. I've had enough and not really sure where to go from here

Request a private examination via your GP.

OP shouldn’t have to do that. Maybe contact PALS?

Was going to ask/suggest vac/negative wound pressure therapy, but looks like they may have tried that already?
What area of the country are you in?

Have you had a recent xray to check for any bone infection?

What sort of exercise do you do ?
the more you raise your heart rate and exercise, the more your blood will circulate and heal !
maybe your in a rut, or find it hard - but starting tomorrow is never too late. If should help you feel better also

Have you been seen by Dermatology?

Does it still have that purple-ish border?

I’m wondering about pyoderma gangrenosum.

I was a runner, did a marathon a year. But physio have advised minimal activity until the wound has healed so other than upper body weights I'm a bit stuck

Not dermatology no, yes it does look bruised around the edge

I’d get a second opinion at The Royal Free in London

Sounds like asking for scans/xrays to check for foreign bodies might be the next step

Any history of autoimmune conditions?

That's the opposite end of the country

Nope, nothing

Let's see: hopefully concerned about his wife's wellbeing and doing what he can to help. Hope that helps, I can tell you're concerned for OP.

I had a non healing wound after a laparotomy (abdominal wound), I totally get the feeling of feeling like it was never going to get better, I had many times of coming home from the treatment room in flood of tears. I had wound discinence after my discharge paperwork said my stitches needed to be removed after 5 days when it was in fact 15… I had some cream prescribed in the end and it got better, so there is an end point eventually. Hope this gives you some hope (I know it’s not the same)

https://www.nhs.uk/conditions/pyoderma-gangrenosum/

Ask for a dermatology referral

Vascular and tissue viability seems to be something that some trusts do much better than others.
Where are you based? Your GP or current care team might be able to refer in to another clinic

Our plastics nurses are shite IMO. Can’t cope with anything chronic or complicated.

I’d be asking to see my local tissue viability team via the practice nurse. I’m a primary care nurse practitioner and we are bloody brilliant with chronic wounds.

Which is the first and most recent photo. When was it last swabbed, does it have any smell, how are you in yourself, any pain and temperature. I'd ask for a scan, swab, blood tests multi disciplinary meeting with plastics, vascular and dermatology.

I think that may be part of your problem. You need excellent specialist care to get ontop of something difficult like this and London is the best place for it. You need someone to take an active interest in it, not a muted response from nurses 'trying approaches' and humming and haa-ing. That's not good enough.

The longer this goes on, the more weakened everything becomes which is why it's now chronic.

Someone really needs to take charge of it. I'd be asking for a second opinion at the very least. Where do you live? You need to get yourself to an excellent teaching hospital.

London Free, Mayday, St Georges, Chelsea and Westminster. This isn't going to go down well but the best doctors are in teaching hospitals in very big towns. Rural and provincial hospital medicine doesn't cut it in complex cases. The teaching hospitals attract the best staff.

You need to get ontop of this and get it going in the direction asap. You are a young mum with 4 kids? Someone needs to fight for your health. The fact you are sleeping all day and exhausted shows the toll it's taking on your body and how you are fighting this with everything you've got but it's not enough, chronic infections can spread too.

Some urgency needs to be added here. It's gone on long enough. I'm so sorry the NHS is so shit.

Umm the dog shouldn’t be alive. No need to feel guilty about that clear fact.

Was swabbed 2 weeks ago and culture grew strep but nurse said she wasn't worried and to see how it goes. I think it smells horrible and I am in a lot of pain.
temp is constant low grade fever 37.5-38 and has been for months, hr never drops below 90. They've said the wound doesn't look infected so it can't be that.

doesnt help I don't see the same person ever so they never have a point of comparison

Might have been staph not strep... one of them

From my link…

Ugh, photo is just screenshot from NHS website - high temperature is a symptom of pyoderma gangrenosum