Ulceration Tips?

As I'm getting to know you all, I'm learning that some of you are dealing with hand and foot ulcerations. Since it can be quite difficult to achieve healing, I was wondering if some of you have tips for promoting healing? If so, please share.

Aren't finger and toe ulcerations a sign of Raynaud's?

I might be able to help better after 13th July! I have an appointment with a vascular man who runs the ulcer clinic at The Royal Cornwall Hospital in the UK. Last year they won an award for a new type of treatment, the first place ever to use it! That's very unusual for Cornwall. I have struggled with ulcers since last September I have 4 at the moment, one of them is quite bad. Up to now I have been being looked after by the podiatry department, but not very well. On one occasion this worst ulcer was cut with a scalpel to remove the dead skin, normally they just scrape the dead skin off as when there is dead skin the ulcer won't heal. Since then I have had to have 3 courses of antibiotics. I am pretty sure that he cut the good skin as well, but I have no evidence of this, it's my opinion I must add. Currently I only go there every 4 weeks and in between the district nurse comes once a week to change my dressings. However, she never has the right dressings and always uses the ones I bought. I might not be allowed to say what I bought, but if I am not then one of the other moderators will correct me! I bought some called Activheal foam dressings. They have a foam padded area and are surrounded by adhesive stuff. You have to make sure that the adhesive part is well away from the ulcer. They promote healing and also the foam padding protects from knocks. They are far from cheap to buy, but if they do the job it's worth it. The other thing is to try to make circulation better as that is one of the causes of ulcers not healing. There are various products on the market some hand held and some that you sit with your feet on. Another idea is to use Manuka honey the medical grade stuff again not cheap, lots of people say ordinary honey is good, but for me it's better to use the medical grade as then you know that it's reliable and doesn't contain other chemicals.

Sheltilife: I hope you can get to a wound clinic for your ulcers. I ran a home health agency and referred patients to wound clinics. They probably WOULD cut into good skin to get rid of all the old bad tissue. And the clinics I worked with gave the patients wound supplies. We used vacuum equipment and dressings also. . I wish you the best of luck. Most of my patients with ulcers had diabetes.

Sheltielife, I'm also aware that Smith&Nephew produce a range of similar adhesive and non-adhesive dressings by the name of Allevyn so you may want to check out price differences if you buy them privately. I had to use them to dress a deep open surgical wound my husband had a few years back - they were excellent and available on prescription.

Someone I can't remember who mentioned vacuum equipment and I looked at a YouTube about it. However, it wouldn't be right for my worst ulcer due to the position of it. It's on the side near the base of my foot right next to my little toe and so there is no way they would get a good seal. I think I did buy some Allevyn dressings a couple of weeks ago. If I am right the problem for me is I am a very awkward patient :-) I have awful trouble with dressings not sticking to me. There are very few that do, most of them just fall off more or less straight away. I found that the Activheal stick fine no problem at all. I don't really mind spending the money if it works, but it's just that they can get them on prescription they just don't get round to it. I have found the link about the clinic at the Royal Cornwall Hospital http://www.rcht.nhs.uk/RoyalCornwallHospitalsTrust/News/NewsArticles/RCHTDiabeticFootClinicteamwinsSilvermedalforresearchrecruitment.aspx. Yes, it's mainly diabetics that get them, but mine is due to poor circulation. The first one was just that I took the top skin off the back of my heel accidentally and it got infected, but the doctor I saw said it wasn't infected! Another one said it was and gave me antibiotics which I thought had sorted it out, but it didn't heal and then a different doctor said it was OK but needed dressing. The nurse at the practice did that and it was her that said it was an ulcer and she was correct and then I ended up at podiatry. The others just seemed to appear for no reason, unless I am over producing from my other adrenal gland which I think is possible as my blood pressure is going up again just like before I had my first one removed and so it's quite possible that my glucose is up I should check it really. If that is the case then although it's not normal diabetes it has the same effect in that glucose is up. It's all very complicated so many things it can be and that applies to my EM as I also have rheumatoid arthritis another cause of EM! What has cheered me up today is that a new car that I ordered at the beginning of February actually arrived today with a hoist fitted so that I can have my independence back again. I can't wait to get out on the road again on my own. So, something positive to make me feel more happy than I have been doing.

Sheltielife, There is also Sugar Treatment for leg Ulcers. I read an article in the Daily Mail regarding this treatment last year the article is still available to read on Mail online. there has also been U.K trials for this treatment & looks to be very effective. Regards Marti

Sheltielife, I am so sorry to hear of your problems with ulcers. I am a retired nurse and that is my biggest fear. I am heavy and unable to exercise due to the EM and horrible heat intolerance. My feet are very dry, they have cracks in the skin, and no matter how much lotion I put on them they do not improve. The more I am on them the worse they get so it is a vicious cycle. I do not know how to prevent the dry cracking skin from becoming ulcers and I would love to know of any suggestions. I do not have a DR now as no one seems to know enough about it to treat me so I feel pretty much on my own. I wish you well Sheltielife and I am so happy you have a car and your independence back.

It’s been a chaotic week and I have just realised that I haven’t updated what happened when I went to see the vascular man a week ago yesterday! He did a few things one of them was a dopler test and confirmed I have poor circulation. Then he looked at my worst ulcer. He is concerned that I might have a bone infection and if so I would have to have at least some of the bone removed. I had to have a foot X-Ray. I haven’t had the results of that yet.

The ulcer had been getting a bit better as the district nurse decided to try another type of thing called adaptic touch Non-Adhering Silicone Dressing which goes on first and then is covered with an ActivHeal Foam Adhesive dressing. She said that would draw the slough out and give some pain relief. It was a podiatrist that put a new dressing on who I told what the district nurses had been using. She said that was wrong and put a different one on, plus they hadn’t got the ActivHeal Adhesive Foam dressings and she used another type, which I have had before and just doesn’t stick to me. I told her this and she insisted it would. By the time I got home it was off! So, I used one of my own ActivHeal dressings.

Yesterday was podiatry at the local hospital. When they looked at it they said it had gone worse. She scraped it and gosh did that hurt! I told her not to as the idea of the Adaptic Touch dressings is that it avoids having to do that and I had taken some with me. Then she discovered I have another ulcer at the back of my heel.

Every single time I have been to my local podiatry department I seem to get an infection, fortunately I have antibiotics on standby so I have started them again. I just can’t stop shivering.

As for cream to stop cracking of skin I am now finding that CCS Heal Balm seems to be better than anything I have tried so far.

Any updates about this dressing? Did it eventually heal your ulcers?

A lot has changed in the three years since that item you refer to.

Things got a lot worse I started getting more and more ulcers. Eventually a year last September I was taken in hospital as an emergency and had to have my right leg amputated due to some bad ulcers. I really should have refused it because things were improving as at long last they found the real reason this was happening. I have rheumatoid vasculitis and this is the cause. I had just started to have Rituximab infusions.

I still have a couple of ulcers on my other leg but they are very slowly getting better it takes a long time one of them is quite large. The dressings that were being used 3 years ago were no longer suitable. The district nurses have tried a few things the latest is iodoflex.

Thank you for the update! I’m so sorry you had to/have to be going Through all that :frowning:

I researched iodoflex and it sounds great! But contraindicated in people with hashimotos and guess what my mom has lol… Uuugh

I have had problems with the iodoflex dressings. Very painful. The nurses said they would smart for a short time, but it wasn’t just that they hurt all the time so it’s back to what they were using Actiform Cool. Also I went into kidney failure when I had my amputation. My kidney function is fine now, but the leaflet about iodoflex says if you have had kidney problems not to have it.