An Eternally Healing Wound

[Coopladoop]

Hey all,

New member/casual diver here. We had a scufuffle at work some weeks ago, and I've recently found myself now doing very shallow-water industrial diving.

As it so happens, some time ago a crooked piling form toppled over and scraped off a chunk of skin at the back of my heel before I could get clear.

Since then, the wound has been *trying* to heal, but it would seem to me that every time, which is nearly every day, I enter the water the healing process begins anew.

I'm diving near the mouth of a bay/marina, in the Caribbean ocean- so I believe the salt water is of more help than detriment(should be noted that disturbing/displacing sediment on the bottom is commonplace in my line of work, however)- but the fact it is a liquid seems to be preventing a scab from forming for any length of time.

I'm concerned the wound is being denied the conditions it needs to heal, and furthermore that eventually(irrationally) my body might decide to stop trying!

What can I do?

I appreciate any suggestions, comments, or help.


Thanks!

 

[uncfnp]

It is a myth that a scab promotes healing. It fact it can slow it down. My guess is that it is a combination of depth, size and the repetitive trauma that a wound on the heel would experience.

Without seeing it I can only suggest something like a Duoderm dressing with extra tape to secure during dives. The dressing itself is meant to stay on days. And only warm soapy water to clean. No peroxide, alcohol or other chemical cleansers.

 

[Coopladoop]

It is a myth that a scab promotes healing. It fact it can slow it down. My guess is that it is a combination of depth, size and the repetitive trauma that a wound on the heel would experience.

Without seeing it I can only suggest something like a Duoderm dressing with extra tape to secure during dives. The dressing itself is meant to stay on days. And only warm soapy water to clean. No peroxide, alcohol or other chemical cleansers.

Oh? Huh. Didn't know as much.

The depths in question rarely exceed 25 feet, if that plays a part.

This dressing you mention, is it able to remain secure while sliding in/out of a wetsuit?

 

[Bubblesong]

I hope this heals fast, but in case it doesn’t.
3 Reasons Why Most Wounds Won't Heal - Advanced Tissue
You have medical insurance? One of the new miracle cures for slow healing wounds is time in a decompression Chamber.
Here is a hyperbaric medical contact that might be useful:
http://www.vihealthdirectory.com/pages/all_islands.php?allcats=Hyperbaric

 

[Coopladoop]

I hope this heals fast, but in case it doesn’t.
3 Reasons Why Most Wounds Won't Heal - Advanced Tissue
You have medical insurance? One of the new miracle cures for slow healing wounds is time in a decompression Chamber.
Here is a hyperbaric medical contact that might be useful:
The VI Health Directory - Hyperbaric on All, Virgin Islands -

No insurance, but if it comes to it I can pay out of pocket.

It really looks like a surface-level matter, perhaps on the level of a scrape falling off a bike or the sort- so shelling out cash for advanced treatment would be an option preferred if none else work.

Edit: Apologies for the wonky format

 

[Duke Dive Medicine]

Hi Coop,

Salt water is probably impairing it from healing, and exposure to salt water increases the risk of infection. The Duoderm is a good idea - actually any hydrocolloid type dressing will do. Wash the wound with plain soap and water thoroughly beforehand. Cut it as large as possible and avoid folds or ridges in the dressing. Like uncfnp said, I'd get some good occlusive tape to go over it, overlapping the edges. Blenderm by 3M is a strong, occlusive tape that should stay on while you put your wetsuit on as long as you're careful. Make sure the skin around it is dry before you put the occlusive tape on. Blenderm is vulnerable to water getting underneath the edges so you may even want to put some tincture of benzoin on before you put the tape on, just for extra stickiness.

If the dressing stays intact and you are certain that there's been no water leakage into it, it can stay on for several days. If you suspect that any water at all has gotten underneath it, remove it and wash the wound thoroughly with soap and water, then apply a new dressing. Be mindful of signs of infection - pain, redness, swelling, warmth, purulent discharge, fever - and get medical help immediately if you see any of these or think the wound is infected.

Best regards,
DDM

 

[Coopladoop]

Hi Coop,

Salt water is probably impairing it from healing, and exposure to salt water increases the risk of infection. The Duoderm is a good idea - actually any hydrocolloid type dressing will do. Wash the wound with plain soap and water thoroughly beforehand. Cut it as large as possible and avoid folds or ridges in the dressing. Like uncfnp said, I'd get some good occlusive tape to go over it, overlapping the edges. Blenderm by 3M is a strong, occlusive tape that should stay on while you put your wetsuit on as long as you're careful. Make sure the skin around it is dry before you put the occlusive tape on. Blenderm is vulnerable to water getting underneath the edges so you may even want to put some tincture of benzoin on before you put the tape on, just for extra stickiness.

If the dressing stays intact and you are certain that there's been no water leakage into it, it can stay on for several days. If you suspect that any water at all has gotten underneath it, remove it and wash the wound thoroughly with soap and water, then apply a new dressing. Be mindful of signs of infection - pain, redness, swelling, warmth, purulent discharge, fever - and get medical help immediately if you see any of these or think the wound is infected.

Best regards,
DDM

Will follow this suggestion, thank you for the detailed reply DDM!

 

[iamrushman]

you could try a plastic bag over the dressing to help with donning and doffing your wet suit....

 

[Rred]

Coop, what DDM said. Absolutely, clean, cover, seal, recheck for seal integrity.

These days there are too many critters, in or out of the ocean, that like to eat people one small bite at a time, and we don't have antibiotics that work on them all.

It can be hard to find a wound management clinic or specialist who knows their job, some actually do more harm than good. I was very unimpressed with the care a relative was getting (from a generally respected hospital) two years ago. Read up, asked the doctor some questions, was even less impressed. Took the relative to a nationally known wound center and they actually said what I had found online from a reputable source: "This would be good care in the bush, but totally unacceptable to US national treatment standards." And instead of two months, it was cured and gone in two weeks.

So, there are pros and there are pros.

You don't say just what the details are--but this would be job-related, worker's compensation in the US. And any reputable employer should have the decency (and economic fear) to SEND you out for proper treatment, even if that means starting with ten days out of the water.

The little things can snowball very suddenly.

 

[Umuntu]

you could try a plastic bag over the dressing to help with donning and doffing your wet suit....

I learnt the plastic bag over feet and hands trick to lubricate putting on a wetsuit from my kids sailing class. Now I use it all the time.