Who do you beleive???

Posted , 2 users are following.

I am getting quite frustrated with the different attitudes to the treatment of these abcesses, the misleading guidelines we've received, and the vastly different standards of dressing applied.

When my son had his op we were told it was a simple incision and drainage we were due to go away two weeks later and the surgeon told us it should be fine by then. At first he was having the dressing changed daily and was told not to allow it to get wet. The wound was being padded with and alginate ribbon. So when he had a shower we were VERY careful to stick clingfilm over the dressing etc. All was ok for the first week or so, when the district nurse came the padding fell out within hours but it was a weekend and we couldn't do much about it. I had seen how the dressing was changed and as we were more worried about premature closure than anything else I just packed it enough to allow for a \"tail\" for drainage. Suprisingly the nurse who saw it said it was a good job and I had acted wisely. So we went on holiday and the local surgery and hospital had arranged dressing appointments which was very good of them. We were told it would be fine to have it done every other day to give us time to enjoy ourselves. The first nurse he saw while away said they never use alginate as it has a tendency to break down and can leave behind fibres etc which themselves set of infection. Amother nurse prescribed Differin cream as he still has several small boils over his bottom. They also advised anti-bacterial washes etc none of which we had been told at home.Throughout the holiday several lots of dressings came off and the packing came out but I just redid both when this happened. The nurse at the local surgery actually thought I was a qualified nurse she said it was done so well! So eventually we come home. They decide he needs to revert to daily dressing for the first so he's at the surgery every day Monday to Friday. There is a junior nurse who has told him she is concerned there are still so many blind boils and things don't look too good. Then on Friday the senior nurse declared that if the packing falls out over the weekend just let it heal! Well we weren't going to let that happen as you cans still definitely get packing into the wound. Today the same nurse has said it's going to heal in it's own time but changing the dressing every other day is not going to allow it to settle and heal.

He is convinced he will need a second op because of the spread of the other boils and he feels he would rather get it over with sooner than later, particularly as he will be moving form college to employment. As he says he doesn't want to jeopardise a new job by being off with this problem for weeks on end. Have others found this discrepancy in standards, if so how have you dealt with it?

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10 Replies

  • Posted

    Firstly, do not let the wound \"just heal\" as it needs to heal from the inside out, if it closes over it can trap a pocket of infection in and start the whole process over again. You are doing the right thing by packing the wound yourself when it falls out. As for fibres being left behind, as long as it comes out in one piece i wouldn't worry and you can flush the rest out with saline solution. Do you think the \"boils\" look like they are abcesses or just spots? if they are abcesses you need to see the surgeon again and get them seen to.

    One piece of advice i was given was not to pack the hole to tightly as it lets the wound have room to heal. also i found that when i was packing every other day it seemed to heal quicker as it didn't disturb the new tissue.

    Best of luck with the healing process, the body will heal in its own time and everyone is different. If you have any major concerns don't be afraid to contact your surgeons secretary, sometimes the surgeon will speak to you over the phone.

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  • Posted

    Poorlybum thanks for your message! It's hard to believe but I think I had a premonition things were not right. Last night after I posted my message my son came to me at about 10.30 pm to tell me things felt \"weird and sticky\". I took a look and discovered most of the packing had come out again so I prepared to do my usual and just put a temporary \"tail\" in. However I could see the hole did not look quite the same as usual so I applied some gentle pressure and .... well it wasn't nice! Blood pus and one hell of a bad smell. I realised I had to do something drastic so I boiled an old medicine syringe and some tweezers etc in water, mixed some saline solution and gently bathed it out. He was due for a redressing today so I went with him so we could voice our concerns. They aid from what I described last night it appears there may still be a sinus left and it has become reinfected. They have given him more anti-biotics and another appt for tomorrow, and they have shown me how to change the packing so I can deal with it over the weekend. He is feeling pretty down and I had nightmares all night. He's in his last 8 weeks of a performing arts diploma with the \"Big Show\" due on the 16th May, but the overall effect is making him pretty drained as I'm sure some of you can appreciate. I've asked today what the worst case scenario might be i.e. would he be assessed on what he has done or would he fail.

    He already has a chronic pain condition and fought his way out of a wheelchair a few years back this just seems so darned unfair.

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  • Posted

    Gosh I applaud your resourcefulness [b:8497b76127]BristolMum[/b:8497b76127] smile Yes these things are a terrible affliction sad
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  • Posted

    Hi

    All I can say is keep strong and keep asking questions! I've had 2 ops where they stictched me up and things have never gone right in the healing process aquacell and kaltistat have been used nothing happens ever! I have been on and off antibiotics and off work since January! Being an actor also I have not been able to go to castings or take part in local shows it's a nightmare!

    I recently had an MRI scan to see the problems and now await an operation this month!

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  • Posted

    Hi to all my son has had 6 operations for his pilonidial sinus and there was very little infomation forthcoming from the medical profession about this terrible condition .The doctors tried all different ways to operate and lots of different post op care ,after 5 operations and 5 failures to get the wound to heal we were desperate and running out of money, as in South Africa you have to pay for medical procedures and to see a doctor, you have to pay the hospital as well. medical is not free . After the 6th operation my son had in addition to the doctors post op care hyperbaric oxygen treatment , to help the open wound heal , this was the turning point , the wound healed and he has not had a reocurrance for 5years now.

    If you are having problems with the wound not healing, check out Hyperbaric oxygen treatment in addition to post op care

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  • Posted

    Well i thought it was time I updted you all. I guess you thought his problem had healed and we had left the site. No such luck. It's beena yoyo ride, closure, pressure, leaks, closure pressure leaks you all know how it works. Several courses of anti-biotics etc the end we got so frustrated with our old Gp as the nurse was not writing everything she said on the screen and they would not re-refer him that we changed practises. The very first appt with the new practice they agreed to refer him straight back to the surgon so now we are waiting on that. He now has much more distinctive pittiing than he had before, and there is a new hole just below the op site that opens up occassionally when the pressure is bad. He has just been given another course of anti-biotics but he has decided he is not going to take them unitl two weeks time as we are going away and he thinks that if he takes them just before we go it might stabilise things a bit while we're away.

    He eventually finished his college cours and has been looking for work, but to be honest I don't think he would be fit for work at present as the last two weeks things have been building up and releasing more or less every other day. Part of me feels it wuld be better to put in a \"tail\" again as at least that avoids the pressure build upo whcih is the really painful part, and as it's clear he will need another op it seems that conserving things in the most comfortable way is probably the best idea.

    Our old GP was totally against the idea of maggot therapy so far that has had a neutral respnse at the new surgery but it is something he feels he would be willing to try.

    I will keep you informed of developments.

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  • Posted

    The fact he has multiple boil like lumps could point to a condition known as Hidradenitis suppurativa or Ane Inversa. Sinus can also be a symtom of this. The fact he has multiple boil like lumps in one area is more in line with this than just PS, there is someinfo on the web you may find useful and perhaps sugest this to your doctor.
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  • Posted

    Salt and PEPPER, Thanks for that inoformation, it does sound like there is more to hs condition than just the polidinal sinus. at one time my husband develeoped boils all over his torso but that was put down to stress as he had a breakdown a few months before that episode.

    It will be worth mentioniung the Hidra..... phew the names these things have! just so it can be ruled out if nothing esle.

    Once again thanks.

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  • Posted

    Bristolmum,

    Has your son / you considered enquiring about the cleft lift? It's a fairly new surgery (8 years or so) that is more and more being used over here, there's only about 10 surgeons in the UK that do this. I had a failed stitched up surgery last year and finally had the cleft lift performed last week - I'm already on my feet and doing most things. It's also got a very low recurrence rate and quick healing time - it may be an option for your son? There's very little aftercare too, no packing etc which has been a lifesaver for me. The downside is you may have to travel to a surgeon that does this, your closest will be either London or Portsmouth.

    Just a thought, I didn't want to go through the hell of another surgery again with all the drama and nurses and toing and froing the GP's and on antibiotics almost constantly, so far so good. Hope this helps.

    Nat x

    P.S. it's ur right on the NHS to be referred to any surgeon you wish, so that won't be a problem if you find another one

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  • Posted

    Hello all, well we saw the consultant today, he seemed like a really nice guy. he explained that my son's abcess is actually much higher than usual (almost at the very top of the cleft) and that the cleft lift procedure would not be approprate in his case. We queried an MRI scan prior to surgery, but he said that spots on my lads bottom do not appear to be related to the cyst so there. probably wouldn't be any point. He did tell us it is likely to recur until my lad reaches 40 or so,whcih I didn't feel was very encourging, but at least was honest. He also commented that my lad is not very hairy compared to the people that this normally effects, but he is a bit overweight and has a predisposition towards acne and \"spotty bum\".

    The procedure he intends to use will mean lifting skin and removing an area of infected flesh, then stitching the skin back over and putting a sort of pressure dressing over it to stop anything from being able to fill the cavity. He said the stitches will have to stay in about three weeks to make sure the skin is strong enough not to split open again, and that it will be pretty uncomforable for about three weeks unitil the dressing comes off.

    It sounds similar to the procedures a few people have described here - none too sucessfully, but then I guess the success stories just go on and live thier lives without hanging round forums looking for better solutions, so I;m going to crtoss my fingers and hope this works for him.

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