Wound breakdown and tissue necrosis, can anyone help?

As a lot of you may know I have had trouble with my wound for a week now post surgery on 29th Feb. Today I was back for redressing after having had inadine dressings on since Monday. The BCN took one look and fetched the surgeon who said the blood supply to the vertical part of the inverted T had died and the tissue had necrosised. After much deliberation she decided to debride the dead tissue and dress to try and get the wound to heal. She used a scalpel which only hurt when she got to the good flesh and then I had an iodine scrub before having a manuka honey dressing on. I have to leave this until Monday, they gave me some tegaderm to stick the edges down with should they start to lift and I’m not allowed to bath or shower. Tonight it’s really sore which is to be expected as it’s open flesh.
Has anyone had this happen? The constant said it’s really common and will be fine but just take a while to heal. This will obviously delay chemo. Xx

The manuka honey can cause pain in itself…I had horrendous problems…have you implants?

The body may be rejecting them.Also the tegaderm can be uncomfortable.

I was a community nurse,and did my own dressings,for 6 months altogether.Inadine is excellent for healing.

yes,leave in place,as suggested,but if you feel unwell,get a temperature,and area gets hot,seek medical advice.

Take regular paracetomol for the pain,rest up,and also go for walks in fresh air to get blood  circulating.

Let us know how you get on.You will find different medical staff have different ideas as well.

gentle hugs…? 

Hi Jillybee thanks for replying. This morning is the first morning I have woken up and pain is not my first thought. I don’t have implants I had a therapeutic mammoplasty with ANC. I have a super sensitive nose which over the years had driven my hubby mad (except for the time I smelt gas and it turns out the gas man had left one tiny pipe disconnected in our boiler. The leak was so small his machine was struggling to pick it up but good I noticed it) anyway less of the gas man. For days I have smelt this horrid smell and in a former before kids life was an ODA in theatres so I knew it wasn’t a good sign but despite several people inc professionals looking nobody else could smell until yesterday so they were just talking about skin dying and it would just peel hence the inadine. It was a relief to finally get something done. I know some people swear by honey for colds etc but was surprised when the cons suggested it. Did the honey work for you or did you stop because of the pain? I am hoping this will stay on they have used a different type of dressing over the top and also some tegaderm at the bottom as this is where it tends to come adrift. I hate opsite/tegaderm style dressings, they never hold up to their waterproof claim however gentle the shower.
The one on at the minute is a very soft slightly padded pink one. Think it was called allevin or something similar. They did say any temp come straight back or over the weekend go to a and even.
Again thank you so much for replying. It’s good to have a professional/support mix reply xxxx

Goodness that sores awful and sore. Hope they have it sorted now. Big hugs x

Sounds awful I meant stupid phone. Lou x

Thanks Lou. My phone keeps doing the same ? it changed the name of one lady to Podgy oh my life I was so embarrassed.
Well today I’ve had one dose of paracetamol whereas in the last week I was on tramadol and paracetamol and counting the minutes until I could have them again. So something is definitely working. Just hope it continues to do so. Phoned the BCNs with an update as requested and had a good laugh with them, now known as Sugar T*t thanks to Emma off here. Xxx

I had terrible trouble after my mx and implant. started chemo before the wound had healed completely. After the first two rounds of chemo the wound opened up and I put on antibiotics, then had to o have implant removed. Awaiting further recon before Easter!

Sorry meant to add that manuka honey was fab for healing!

Oh Butterfly you’ve made my day. I still see the gas man’s face when he realised I was right and there was a leak!! Also so many people have physically sniffed my boob Inc a doctor and three different nurses. It was a week before anyone else could smell it and it was visibly showing. My hubby told me I shouldn’t be surprised nobody believed me. He said people aren’t going to go on what you say just because you’ve got sixth sense. I was livid. It’s not a sixth sense it’s just a better sense of smell than other people but now I’m not the only one!!!
I have now become a compulsive t*t sniffer. Can I ask could you still smell anything through the honey dressing? I couldn’t but today I can. Nowhere near as bad and I’m desperate to keep it on until Monday when it will be four days and the same nurse and consultant will see it. My only other option is to ring the ward over the weekend but they won’t have seen it and it’ll be the on call doctor.
Thanks again Bboo xxx

Hi butterfly. Thank you so much for checking up. I have two egg shaped holes about the size of a 50p coin. And have that stuff plus some black skin which they say is starting to lift. However they don’t clean it odd and blow dry. Last night a health care assistant did it. She didn’t prewarm the honey dressing and instead of popping the whole gauze strip on she cut bits off the size of the hole. Cos it wasn’t warmed I had stiff gauze with the odd blob of honey on and all night had stabbing pains. It was like a patchwork quilt. The pain has gone today so I guess my body heat has softened the gauze but am convinced not enough honey. The was another HCA with her telling her what to do but she wouldn’t listen ?

I’m due to be changed tomorrow so going to own gp will make sure it’s put on properly and then just leave it for 5 days. Thanks again xx

Hi Jillybee. No they didn’t blow dry it, that was butterfly’'s nurse. The dressing did not last but luckily (like thought) it was done by one of my practice nurses Friday. I had stood my ground at the hospital saying what if they don’t have honey as I didn’t the the clinic until after 7.30pm so couldn’t even ring until the next morning giving them just 24 hours notice. They gave me a honey dressing but that was it. Unfortunately the practice didn’t have the allevyn they used at the hospital so used as close as they had which was like a crinkly outside to it kind of dressing. It barely had a sticky margin around. To be fair it was the same margin as the allevyn but because that is nice and thick and soft it’s always OK. So…long story short literally 24 hours later and I’m in the bathroom when a wet soggy gauze she had put underneath the wound and covered with a tegaderm (all along the bottom edge to secure it) fell on my foot. Looked in the mirror and it was all just tethered on at the top. Rang the ward as per instructions. Flip my life!!! Now they don’t know I was originally an ODA/aanesthetic nurse (depending on what the hospital called us 24 and more years ago) so do have some savvy plus my eldest who is severely disabled with an intrathecal back often pump came home with a back wound leaking csf which I was taught to dress at home (another freaking long story! !!) Sorry back to the point. So they don’t know I am not clueless. BUT all they would was ask me to write down what I wanted to sort it until today. I write a long list inc a dressing pack and saline and off hubby goes. Five mins later rings to say the ward don’t have the allevyn and can I have instead?? Given when I qualified sleek was still a tape of choice I only know what dressings I’ve come across. All I could say to him was something that soak up the stuff produced by the honey and wound. He comes back with the same ones as the gp. Luckily they also arm him with sterile gauze tegaderm film and opsite wouno dressings. Now being where it was meant I couldn’t see too well lying down so quick lesson to hubby on aseptic technique and we’re off. With the aid of mirrors and lots of instructions the whole thing is changed. Now the gross bit. On one of the wounds the necrotic skin/slough had lifted and as he wiped it with the sterile saline and gauze it came off and underneath is beautiful and pink. (Nearly pooped myself at the size until I realised I was looking in the magnifying side of the mirror) The other wound is almost there. He made a better job of the honey dressing than the last two occasions and our bodge job has stayed on.
In a way I’m glad it happened as I was abe to see after just twelve days what an improvement there was. However what if I wasn’t able to do it? There was no offer to go in even when I spelled out this was as open wound. I guess I would have had to go to a and e clutching the sodden dressing to me somehow.
I’m hoping that my appointment at 12 today will see the other side as good. My question is what happens now? All my now nicely pink and healthy exposed flesh will still need dressing but what sort are they likely to use? Is the honey still of benefit? Or will it be some other moist type thing? Given that they are egg shaped 50p sized wounds how long roughly would you say they would take to be sorted completely?
Sorry for the long reply and thank you for checking in on me xxxx

Oh you poor thing what a palaver!! The hospital should have given adequate supplies and then you can get your dressings (honey,allevyn or whatever) on prescription. if the chemist doesn’t stock if they will order it in for the next day.  Some are costly which the gps  don’t like but it’s better than wasting inadequate  dressings.

Well I’ve just come back from being dressed (the wound not me ?) by the BCN. She is livid at the ward and they are already having issues so this has been added to the list. Got attacked by the ninja scalpel again looking so much better. Honey back on let’s hope it stays this time.

Oh my life I have just read my long post back. Full of typos sorry. I was doing it without glasses and posted without checking. The BCN was talking about a pico today when it gets smaller but in the meantime has tethered the allevyn down with spare pico strips.

Goodness Bottyboo what a nightmare. I really hope this gets sorted. Thinking of you Lou x

Oh my goodness, what a fiasco. Like jillybee I had the pleasure of seeing my implant through a hole in my wound. My surgeon dressed it BT didn’t take the plastic cover off the honey strip - hence the skin broke down very quickly. I did a better job if dressing in at home!

Hope it works for you this time, you don’t need the added stress.

Well thanks to lovely BCN and my surgeon who came into the dressing change I have now divorced the honey and am currently on silver dressings with an extra marital affair with a cheeky bit of inadine at each end. No hope of promotion to gold tho ?

Hi Butterfly. Thank you for checking in on me. It’s the usual nightmare of me trying to get to see practice nurse then having to visit walk in centre at 8am every day Friday to Monday then Tuesday back in at the docs, then daily until review next Thursday. So hopefully dressings ordered, if they’re not there for tomorrow then the surgery have different silver dressings but still silver dressings at the end of the day. It will just be the allevyn. The ones the surgery had were a different type of absorbant dressing but the outside bit was very thin in comparison. The nurse did say she wasn’t surprised it didn’t last.
I’m sure the answer to this is very much how long is a piece of string but the two wounds are about (according to hubby’s scientific analogy) as big as the bottom of a ready to drink ribena juice bottle. I had one next to me when I asked him lol. If they are that size what potentially could we be looking at timewise presuming they heal normally now? The reason I’m asking is because the onc said chemo needs to be within three months and if it takes longer it may not be an advantage.
Good luck tomorrow will be thinking of you xxx ?

Today my dressings have reduced from daily to alternate days - woohoo!!! Also after seeing the dressing my hubby put on at midnight Sunday after the dressing the district nurse put on at half two in the afternoon fell off they’ve said we can do them at home with reviews once a week