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What Causes Itching Sensation At The Site Of Skin Grafting?

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Posted on Mon, 2 Mar 2015
Question: Hi,

My mother had a skin grafting 8 years back on foot bridge on a wound which was taking time to heal. The skin grafting was successfully done and healed. However lately few days back after 8 years she had a itching near foot bridge which she scratched which caused wound on the same skin grafting area. The wound is increasing. We visited lately to a doctor and he advised to clean the wound with diluted detol water, apply T-bact cream followed by bactigras and then dress it up. He also advised the wound to be kept open for 2 hours a day.

My mother is rheumatoid arthritis patient and she is undergoing with below tablets.

T.Proxym XT 2 tabs for 10 days then 1 to continue
T. Folitrax 10 mg 1 tab after lunch
T. Folvite 5 mg only Wednesday morning
T.Ezycal 500mg once in a day
T. D 360 XXXXXXX once in a week
T.Dompan once in a day
T.Fludac 20 mg once in a day
T.Ativan 1000mg once in a day


Can you pls advise whether any of these tabs may be creating problems in healing the wound. Lately T.Proxym is the new tab was added to her list which I am suspecting may be the cause?


Also any advise that would allow the wound to heal faster is much appreciated.

Aslo my mother sits in the sun daily morning for 30 mins with the wound closed. Shall we keep it open in the sunlight which will then heal quickly?. Pls advise



doctor
Answered by Dr. Geetika Paul (36 minutes later)
Brief Answer:
Kindly provide pictures and details

Detailed Answer:
Hi
I understand your concern regarding your skin problem and I hope I am able to help you in the same.
Your mother seems to have developed an infected skin wound .
I would like to have a look at the exact skin condition.
Please click some close up pictures of the affected area and upload them here on this page.
Also please tell of your mother is diabetic or has she ever got her blood glucose levels tested.

I am sure I will be able to help you better once you provide me the pictures along with the above details.

Dr Geetika Paul
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Geetika Paul (47 hours later)
Hi, I've attached the pics. Also my mom is not diabetic as sugar test was done 7-8 months back. Pls advise. Thanks
doctor
Answered by Dr. Geetika Paul (14 hours later)
Brief Answer:
Need for oral antibiotics

Detailed Answer:
Hi again

Thanks for the pictures

Your mother seems to have developed an infected skin wound .
Proper care of the area is very essential and you seem to be cleaning it well .
keep the affected area clean and dry .
Continue application of the antibiotic cream .
Since your mother is on methotrexate for arthritis, that is why she is immunocompromised and has developed such an infection .
So in my viewpoint ,she might need a short course of oral antibiotics like azithromycin or Amoxycillin clavulanic acid for rapid and complete recovery . Also since you are already cleaning the wound well and applying an antibiotic cream ,still the round is persisting.
So would advise you to discuss the same with your treating doctor .
Also it is better if you can keep the wound open for a longer time since it will fasten the healing process .


Dr Geetika Paul

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Geetika Paul (6 hours later)
Hi, Many Thanks for your reply.

Lately the doc has increased the dose from 7.5 mg to 10 mg of Folitrax, which has methotrexate, I guess this may be stimulating the wound in bad way.

I hope we are dressing her wound well.?.

Also, we are keeping her wound open daily during evening time between 7 to 9 pm daily , I guess if we keep her wound open during day when she takes sunlight that will speed up the recovery?. Pls advise. Thank You
doctor
Answered by Dr. Geetika Paul (25 minutes later)
Brief Answer:
Care of the affected area

Detailed Answer:
Hi again


You need to understand that methotrexate is a very essential drug for her problem,so it can surely not be stopped or tapered .
Patients on methotrexate are more prone to develop any kind of infections than general population. But owing to the necessity of the drug ,one has to continue with it while taking care of any infections that develop .
In my viewpoint,if you keep the wound open and clean it properly two to three times daily followed by application of the medicine ,the wound will heal soon .
Sunlight will hasten the drying and healing of the wound ,so will be beneficial.
Addition of an antibiotic like azithromycin 500 mg once daily for four days will surely hasten the recovery process .

Dr Geetika Paul
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Geetika Paul (27 hours later)
Many Thanks doctor for such a detailed explanation which was very useful. I will check with both the docs ( rhematologist and skin specialist) to advise if azithromycin can be given.

We do dressing daily at night as there is no one at home to do the dressing throughout the day. However we keep the wound open for 3-4 hrs during evening time.

One thing I've observed today is when we keep the wound open my mother complains that there is lot of burning sensation she feels in the wound however when it is closed she feels better. I am not sure the burning sensation is a good sign or bad sign?.

Thanks again!
doctor
Answered by Dr. Geetika Paul (4 minutes later)
Brief Answer:
Care of the wound

Detailed Answer:
Hi again

When you keep the wound open ,the wound tends to dry up a bit leading to feeling of stretching of skin which might be perceived by some patients as pain or burning . But it is surely a good sign .
If you are doing dressing just once ,make sure you clean the area well and do not allow the ointment to remain stuck to the wound. Try to clean the previous day's medicine well before applying a new layer of the medicine .

Dr Geetika Paul
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Geetika Paul

Dermatologist

Practicing since :2008

Answered : 2606 Questions

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What Causes Itching Sensation At The Site Of Skin Grafting?

Brief Answer: Kindly provide pictures and details Detailed Answer: Hi I understand your concern regarding your skin problem and I hope I am able to help you in the same. Your mother seems to have developed an infected skin wound . I would like to have a look at the exact skin condition. Please click some close up pictures of the affected area and upload them here on this page. Also please tell of your mother is diabetic or has she ever got her blood glucose levels tested. I am sure I will be able to help you better once you provide me the pictures along with the above details. Dr Geetika Paul