13 replies to this topic

[Kelsey]

A few weeks ago, I noticed a sore/blister type area on the back of my ankle under my afo. As I was at the physio clinic at the time, the nurse told me to keep an eye on it and get an urgent appointment with the orthotic dept. My appointment is two weeks away.

Today, I had a really good look at it and it looks like a blister that has burst and has pus coming out. The whole lump sticks out and is really red. Just wondered what the best thing is to do with it until my appointment. It doesn't hurt obviously but it is really big and a bit yucky looking. Is there any type of cream I should be applying or is there a particular type of plaster I should be using.

[greybeard]

One thing you should NOT be using is your AFO. Keeping it dry and covered is probably best, but others may know better than me.

[wheeliebear75]

An antibiotic ointment such as Neosporin is the 2nd thing I would do....the 1st being as GB said....STOP wearing your AFO for the time being (it'll only keep rubbing it raw & make it that much harder for any new skin to try growing over the blister-hole). If the area around the blister itself becomes red than get your butt into an urgent appointment ASAP even if you have to go in to E.R. or an urgent care....infections especially those that started from sores below our injuries are particularly hard to get rid of once they get going.

[zia]

What is an AFO?

[mellowgator]

zia, on 04 September 2011 - 02:24 AM, said:

What is an AFO?

Ankle-foot orthosis (AFOs)
Example of an ankle-foot orthosisAnkle-foot orthoses (AFOs) are orthoses or braces (usually plastic), encompassing the ankle joint and all (or part) of the foot. AFOs are externally applied and intended to control position and motion of the ankle, compensate for weakness, or correct deformities.[9] They control the ankle directly, and can be designed to control the knee joint indirectly as well.[9] AFOs are commonly used in the treatment of disorders affecting muscle function such as stroke, spinal cord injury, muscular dystrophy, cerebral palsy, polio, multiple sclerosis and peripheral neuropathy. AFOs can be used to support wasted limbs, or to position a limb with contracted muscles into a more normal position. They are also used to immobilize the ankle and lower leg in the presence of arthritis or fracture, and to correct foot drop; an AFO is also known as a foot-drop brace.

[qbounce]

Big, red and yucky looking sounds a lot like a pressure sore, and feet are very easy to get them on.
Keep any and all pressure off it, including shoes.
Can't you walk into your primary doctor's office on an urgent request?

If it is in fact a pressure sore, the longer you wait now, the worse it'll be for you to nurse in the long run.

[BigSis_K]

I'd be interested to see what your Dr. says it is. My brother developed a foot FULL of blisters that sound just like you describe. aaannnddd he had the "boots" on his feet for about a week (immediately post injury), not long after they came off we noticed a bump, which progressed into many blisters, nasty puss-filled, blisters - hossie staff had infectious..blah blah team examine & I never heard a final answer...(couldn't be pressure sores as there was no pressure on his feet, he's been in a bed for a month)

anyway, my mom was putting Dr. Nailer's (udder balm? I think it is) on 'em & they're healing up pretty well (nicely scabbed & totally dry). Hossie dr.s had no problem with her doing it, especially as it seemed to work.

[Kelsey]

I went back to Orthotics for the so called 'emergency' appointment and I think he has made matters worse. He had a quick look at the sore and said, "no problem, give me 5 minutes, and I'll be back". Off he went with the AFO only to return a couple of minutes later. "Here you go", he said, all sorted. Basically what he had done was cut out the piece of plastic at the back of the AFO. Ok, yes, the plastic was no longer rubbing but I was still a little bit worried about his relaxed attitude.

He did say he was going to order another AFO which was basically the same but had more straps on it to help stop my foot from moving around.

Off I go, back to work, hoping that all would be ok. Spent the rest of the day in my wheelchair so not to push things too much. Back at home later that evening, I had a look and it look pretty red all around it.

The next day, was a pretty hectic day, and stupidly I forgot to have a look at my ankle. When the evening came and I took off my AFO to get into bed, I as faced with a large hole of pus above the original sore. It appears that by cutting an area out of the plastic, it had increased the pressure just above the sore. Can't believe how quickly the skin deteriorated.


Anyway, I am now having to keep off the foot as much as possible and also not wear the AFO. Had a couple of trips today which scared the pants off me.

This is so frustrating. Hopefully it won't be too long till the other AFO arrives, but I am going to make sure there is nothing pressing on the back of my foot. Surely, there must be some sort of AFO that is like this.

[greybeard]

Kelsey, on 11 September 2011 - 05:10 PM, said:

Anyway, I am now having to keep off the foot as much as possible and also not wear the AFO. Had a couple of trips today which scared the pants off me.

Hate to say I told you so.

But what the hell............. I TOLD YOU SO!!

Hope it heals quickly.

[jules]

Are you on antibiotics? as a first line if I get a sore on my foot I tend to use a soak in warm salt water, sometimes this will prevent you having to go on to antibiotics. As GB said stay off it and don't use the AFO.

Hope this helps

Jules

[Kelsey]

Thanks GB and Jules. I now consider myself officially told off.

[brockit79]

Hi,

ok if you still have this seek advice/intervention from a tissue viability nurse via your GP. If the skin is broken they will use sterile saline and sterile gauze to cleanse the area. As already stated don't use the AFO and do not use cream. Even antibiotic cream will be contaminated when you apply it with anything non sterile like fingers or cotton buds.

Dry covered and most importantly pressure free. Ankle wounds are often irritated even by bed clothes. So ensure you are offloading pressure by using a cushion under your legs so that your feet are dangling off at night/lying down. If it persists ask your tissue viability nurse or even better! Podiatrist (;)) to use a dressing which will offload the pressure. a simple dressing will not do this alone.

Happy healing
Broc

[Kelsey]

Ok, I know you all told me and I should have acted sooner.

Had to go to hospital for physio and she took one look at the sore and got somebody else in to see it. Basically I have now got cellulitus (sorry for wrong spelling). The doctor has put me on a very strong course of penicillin. The sore/hole has got a dressing on it too. They have also put my leg in tubi-grip under the afo.

They were disgusted with what the orthotic guy had done with the afo. They said that it was totally useless and really was making things so much worse.

I have emergency appointment tomorrow at 2.30pm to see what orthotics can do.

[guido]

I know I'm late in replying - just going through a backlog of emails. I had this, typically it was at Christmas a while back, so went to A&E as the quickest referral method to see anyone who would take it seriously - I didn't notice it until it burst and I wondered why I had been feeling really unwell!! Long story short, a surgeon scraped off the dead stuff, I was given antibiotics and referred to an excellent dressings nurse at the local hospital.

She was really helpful and apart from sorting me out with the correct dressings for the fastest heal (heel, ha!ha! geddit! ach, never mind...) time she also put me onto http://www.limboproducts.co.uk/ who were lovely and helpful on the phone and their products meant I kept showering as usual.

Also - and the reason I now sell them on my site - she put me onto ankle protectors. I wore one then to help cure (actually I slept with a leg trough for the first bit so the heel had NO pressure on it whatsoever - can prob sell you that 2nd hand if I can find it, and if you're interested?) and now I sleep with one on as a preventative - mine was caused by not rolling over in one night in a different bed (I think). http://disabledgear....sureRelief.aspx

Hope it gets better soon!