treatment of a chronic wound

I am disappointed that there have been no responses yet to my post. Perhaps I should refine my enquiry - and focus only on Algidex Paste. A Google search produces 13,700 hits, and the first five pages only list websites selling the product. However, on page six this patient.info discussion appears at the top.

If this Paste is being sold world-wide, and is so successful, I would have thought there would have been some advice for me, and/or criticisms of my post. I am suspecting that my doctor wants to promote Algidex for his own financial interests in the product. I suggested BNT and he gave a definite no. Just how far can we trust our doctors nowadays - this has to be the subject for another discussion!

Responses from doctors would be appreciated, as well as responses from persons using the Paste, successful or otherwise.

I don't have any experience with the paste you mention, however my grandmother had wounds on her legs that were slow to heal as she was diabetic, and Manuka honey dressings helped tremendously.

Before your write it off as another silly health fad, read up on it, it's actually approved and used within the NHS on certain dressings, and evidence found it to be good.

Here is a copy and paste from the evidence.nhs website

A5.3.1 Honey

Medical grade honey has antimicrobial and anti-inflammatory properties and can be used for acute or chronic wounds. Medical grade honey has osmotic properties, producing an environment that promotes autolytic debridement; it can help control wound malodour. Honey dressings should not be used on patients with extreme sensitivity to honey, bee stings or bee products. Patients with diabetes should be monitored for changes in blood-glucose concentrations during treatment with topical honey or honey-impregnated dressings.

Sub-sections

Sheet dressing

Honey-based topical application

Medical grade honey is applied directly to the wound and covered with a primary low adherence wound dressing; an additional secondary dressing may be required for exuding wounds.

Activon® (Advancis)

MANUKApli®

Medihoney®

Melladerm® Plus

Mesitran®

I'm not suggesting you run out and buy it, but there's a wealth of benefits to be had with this stuff and I've seen it first hand work well.

Like I said, sorry this isn't the direct answer to your question, but I hope that it may help you out, or at very least encourage others to reply

Most areas have wound specialist nurses and clinics in the NHS and private sector.

Google for your area or ask at your GP practice..

Many thanks for these two responses. Concerning the honey applications, I was very interested but my search of the first link:

nhs website A5.3.1 Honey

was inconclusive. The other links were along the lines of companies selling their product, for which I have the same reservations concerning Algidex and Supragel. It appears that wound treatment and care is a growing (profit-making) industry!

Amazon lists one Algidex product with no customer reviews yet, and they have no results whatsoever for Supragel at the moment. My searching is giving me the impression that trial and error is all we can do, and it seems that is what the medics are doing as well.

This brings me to my comments concerning the second response, regarding consultation with the medics. I am certainly doing this with my hospital doctor, my own GP, a private district nurse, and will engage a private doctor if necessary - but so far most of them appear to be no wiser than myself. My nurse is the only one who finds the time to discuss my problem along the lines of trying to find out what will work best for me.

I return to my request for responses from anyone who has used Algidex or Supragel. The honey suggestion still appears to be a possibility, having found a number of other responses along with the above post.

Another option is to self-fund directly to a CONSULTANT specialist, have a google for private hospitals in your area, although it usually costs in the region of £200 just to be seen, the average waits are usually around 1 week.

Then I'm sure you will get a better answer.

It would be useful if you could get your GP to either write the referral, or if he's obtuse, ask the receptionist in the doctors surgery for a printout of your complete record, that way consultant will have what he needs. Make sure you keep a diary of when you've been seen etc and what has been tried so far etc, don't want to teach you to suck eggs or anything, but when seeing a new doctor this is very useful.

So sorry your still having trouble though, chin up

You seem not to have said the actual cause of your wound. Is it an ulcer?

Google on tissue viability and you may find links that can help.

To go completely private seems the the best option, but my finances do not run to that! I am already spending quite a lot on dressings, and with my private nurse who is doing a good job, twice per week using Algidex Paste.

For derek76, and many thanks for the tissue viability suggestions which are proving very informative, the wound appeared last August. It is sited at the back of my right ankle, on scar tissue resulting from an Achilles Tendon injury and repair when I was 34 years old! I am now 71 years young (!), and have had no problems with my tendon for nearly 40 years. I have run, walked and mountain climbed on it, but I do not know what caused the breakout last year.

I was admitted through A&E, the emergency being that I might be losing my tendon. After the first surgery, I was told nothing except that the tendon was still intact. However, after five weeks in hospital there were no signs of healing, therefore the surgeon said only further surgery would help, otherwise the wound would NEVER heal! This surgery would involve a skin graft, and I accepted the advice.

However, in the theatre they decided not to do a skin graft (the ward sister said that they may have decided it would not take for whatever reasons, not given by the surgeon), and I was told it would take a long time to heal - perhaps three months - and I must be very careful with it. Some tendon had had to be removed, to allow 4 sutures (which have since been removed), but the wound is still open, and Algidex Paste was recommended immediately after this second surgery.

I have kept a complete record of every dressing administered during nearly nine weeks on the orthopaedic ward, and the sister noticed inconsistencies between different nurses. My private nurse now is being consistent with the Algidex Paste.

My apologies for the lengthy post, (I could write a book!), and I appreciate NHS care may never be as comprehensive as private care. However, the time I spend here on the computer is, I hope, helping to heal my ankle, and avoid having to spend money which I do not have - short of selling my house!

I have just come away from the NHS Hospital Orthopaedic Clinic, and was seen by yet another, different doctor. I showed him the Algidex Paste which was being used, and he described it as "fancy modern technology", and said the best thing would be to place my foot and lower leg in plaster, as movement there was preventing the healing of the wound on the supposedly sound Achilles Tendon.

My wife and myself are furious, we may have to go completely private, but I wonder where that will take me, apart from homelessness!

I don't think that I am allowed to post a direct link to any services but if you Google wound healing centres you will find something. One I looked at said that you are allowed to refer yourself to this private service as an NHS patient.

"My chronic wound has now had 13 dressings using Algidex Paste (approx. at 3 day intervals) and although there is some healing, on a recent occasion my nurse said that she found it difficult to remove the previous application of the paste, and the wound may need surgical debridement. My hospital doctors (two surgical interventions) are completely unforthcoming, they do not seem to know even about the simple instructions given with the paste."

I continue to draw a blank whilst searching for any customer comments on the use of either Algidex or Supragel. The above paragraph has been posted to several websites selling Algidex, but none have responded. The hospital doctor here who has described these things as "fancy modern technologies" may not be far from the truth.

I am consulting with my own GP this weekend as a private patient, and hope to get advice which is holistic. The Treatment Viability Society in the UK have sent me quite a long e-mail, but regret that they have no members in Barbados to whom I could refer. Their website certainly focusses on an holistic approach. I am particularly concerned about the skin surrounding the wound (the peri-wound skin), and only my wife, my private nurse and myself are thus concerned. All other medics so far involved have paid no interest in this sort of holistic approach, they seem only interested in the wound, and perhaps trying to sell these questionable products. As I have said before, wound treatment seems to be a growth industry.

My private doctor and nurse are working together to remove the remains of the Algidex Paste, the use of which has now been abandoned by my hospital medics. There is a piece still adhering to the wound bed which is difficult to remove, but before my doctor removes it by surgical debridement (which he says he can do at my home bedside) we are trying a treatment with Barbados sea-water every other day, which we hope will remove the unwanted paste. After the sea-water (in a bubbling foot-bath for 20 minutes at each dressing), the wound is being dressed with Fucidin Intra-Tulle, and then bound with a cotton bandage.

We have been recommended to try Supragel and Supracel, but want the wound to be completely clear of the Algidex Paste before anything else is attempted. There has been one suggestion that there can be contr-indications between Algidex products and hydrocels (e.g. Supragel).

I am pleased to report that the sea-water treatment has removed the remains of the Algidex Paste, and has exposed an area of white slough. Whist now searching for suitable de-slouching agents (Suprogel, hydrogen peroxide and now Santyl Collagenase Ointment, this latter one is not available in Barbados has been suggested) we are continuing to use the Barbados sea -water treatment, and the slough is softening and my nurse is beginning to remove it bit by bit with tweezers.

We continue to dress afterwards with Fucidin Inter-Tulle on the wound, covering with dry sterile gauzes, and binding with a cotton bandage. SudoCrem on the peri-wound skin is successfully relieving irritation, and the dressing is being changed every two days. There is some exudate, but there is no infection. Saline solution is used for all cleaning, and the wound is dried before being re-dressed.

I wonder if anyone cares to comment on our self-devised treatment, rather than listening to doctors. The Internet has proved invaluable - perhaps doctors are now feeling the pressure of common and public awareness, similar to when the Roman Catholic Church had to adjust to the common publication of the Bible.

Hello everyone

I am a dietitian and I am interested in anecdotal evidence and your experience with using nutrition to help heal wounds, in particular, the subject of arginine. (common products are Arginaid ligquid/powder by Nestle, Cubitan by Nutricia)

It is an expensive supplement so I am cautious about recommending it.

I'd be grateful if you could share your experiences.

Queeny

I am sorry, queeny 63878, I have not addressed my diet in any way concerning the wound, apart from vitamin supplements.

An update on the progress of my wound-healing might be of interest to some readers, especially De-Royal!

The sea-water treatment was abandoned as no further progress was being made on the healing of the wound. My private doctor recommended Multidex Powder, and we have changed to using this, and still using Fucidin Inter-Tulle as a primary dressing.

I am now able to report that all of the slough has gone, with one minor surgical removal at my bedside by my doctor, requiring no anaesthetic. The wound is about 6cm x 3cm, the Achilles Tendon is not visible, the wound bed is clean and the peri-wound skin is healthy and granulating. Exudate was moderate to begin with, now it is minimal. My doctor says a skin graft would speed things up, but carries risks - at my age I am prepared to wait!

Although Multidex Powder is supposed to be changed every day (De-Royal's instructions), we have reduced this to once every 3 days. Interestingly Multidex Powder contains a sugar, linking up with a honey treatment recommended some time ago!

Concerning De-Royal, again there were no instructions regarding the use of the powder, just as there were no instructions regarding the use of Algidex Paste. We had to obtain the instructions from the De-Royal website, and some nurses were reluctant to read them, given to them by me! Lack of instructions regarding the paste (and nurses were not consistent in their dressing methods at the hospital) may be the reason we abandoned it, and now we have come around to another of De-Royal's products with some success! 

Just a brief update. My wound remains chronic, we have given up on the sea water and other alternative therapies. The peri-wound skin is pinkish but healthy, and gradually growing over the wound bed, now about 15 sq. cm. Unfortunately this last week the wound bed has covered itself with a dark grey material, quite sore with a  slight surface infection but not necrotic. We are treating this with anti-biotic products.

The whole process for us is trial and error, hopefully not too many errors. Perhaps a try it and see approach!