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Hi Dr. Chandrakant, First Thank You For Consultation. Here Is

Posted on Mon, 25 Mar 2019

Question: Hi Dr. Chandrakant,

First thank you for consultation.
Here is another update about my condition.

My surgeon gave me two antibiotics to take together which should help with the skin condition i have, i am taking Clyndamycin 300mg and Rifampin 300mg both twice in a day for two weeks. Today is my fifth day, but i noticed a small black spot on the bottom sinus wound on the edge of it. what is this exactly? attaching picture.

Follow up: Dr. T Chandrakant (0 minute later)

Hi Dr. Chandrakant,

First thank you for consultation.
Here is another update about my condition.

My surgeon gave me two antibiotics to take together which should help with the skin condition i have, i am taking Clyndamycin 300mg and Rifampin 300mg both twice in a day for two weeks. Today is my fifth day, but i noticed a small black spot on the bottom sinus wound on the edge of it. what is this exactly? attaching picture.

Answered by Dr. T Chandrakant (28 minutes later)

Brief Answer:
Looks to be a part of the sinus with a small skin bridge.

Detailed Answer:
Thanks for the query and the image.
The image shows a black spot in the bottom sinus is a part of the same sinus with a small skin bridge.
Hence nothing to worry about it.
It is nice to know that you are taking the said antibiotic, hope to see results of it.
Please continue the local care and management as we already discussed..
Hope for the best as rest of the wound/scar looks healthy.

Hope this answers your query.
Take care.
All the best for early and complete healing.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. T Chandrakant (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (48 hours later)

Hi Doctor,

I want to show you the wound again as im a bit worried about the black spot since it got bigger now. Is this still normal healing process? those particular wound are very hard to heal. everytime it feels itchy and doesnt seem to close up fast. please find attached.

Follow up: Dr. T Chandrakant (0 minute later)

Answered by Dr. T Chandrakant (5 hours later)

Brief Answer:
As detailed.

Detailed Answer:
Hi.
Seen the photos and noted the description.
The black point is in fact a part of the sinus the red part is granulation tissue obscuring the sinus and giving the present appearance.
I can understand the difficulty with pain and delayed healing.
I would do the following in such a situation:
May be - probe the area to know the depth of the sinus.
Wipe out the granulation: scrapping or applying copper sulphate salt or instill a few drops of hydrogen peroxide to see the response. Hydrogen peroxide can be installed by filling hydrogen peroxide in a small syringe and, remove the needed and instill few drops and see the results. there will be bubbling and helps to remove any devitalized tissues, loose granulation tissues and helps healing.
Please discuss with your Doctor, his opinion and preference and whether you can instill hydrogen peroxide on your own.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. T Chandrakant (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (16 hours later)

Thank you doctor, i applied hydrigen peroxide and woke up today the black layer was gone completely. do i keep applying hp everyday? Maybe it well help heal the sinus. or it can be harmful as i heard it kills healthy cells and delays healing?

Follow up: Dr. T Chandrakant (0 minute later)

Answered by Dr. T Chandrakant (9 minutes later)

Brief Answer:
Fresh photos please

Detailed Answer:
Please post fresh photos so that I may be in a position to comment and suggest more.
You are correct, hence the need of timely application and stoppage too.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. T Chandrakant (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (7 minutes later)

Uploaded new picture.
I actually poored direct from the HP bottle rather than drops because i didnt have any instrument for drops , i hope that i didnt over do it.

Follow up: Dr. T Chandrakant (0 minute later)

Uploaded new picture.
I actually poored direct from the HP bottle rather than drops because i didnt have any instrument for drops , i hope that i didnt over do it.

Answered by Dr. T Chandrakant (8 minutes later)

Brief Answer:
As detailed.

Detailed Answer:
Thanks for clear photos.
See the granulation now looks healthy.
Please do the same for other small sinuses.
But use a syringe or a dropper - out in few drops only - maybe just once a day. - just once for now and post pictures.

I hope this will clean out unhealthy sinuses and promote healing.
All the best.
Have a great day...

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. T Chandrakant (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (3 days later)

I have been reading doctor that using betadine or hydrogen peroxide is generally not advised for open wounds and that i should apply topical clindamycin combined with benzoyl peroxide to speed up healing..would you advise me to do that? beacuase these open sinuses seem to really take time to heal. Also question doctor, is it normal to feel a strong (itch and irritation) when i sit especially on the botton sinus?

Follow up: Dr. T Chandrakant (0 minute later)

Answered by Dr. T Chandrakant (58 minutes later)

Brief Answer:
As detailed below.

Detailed Answer:
Truly yes, what you say is correct.
It all depends upon the stage of healing, granulation tissues., whether infected or not and so on. All factors together decide.
The fresh photos show better picture than before. I hope you agree.
I have no experience with Benzoyl peroxide as it is mainly used in acne treatment.
Clinidamycin is an anti-bacterial agent as Betadine is.
With the fresh photos, I think you can stop using anything locally for a few days and apply only dry sterile dressings. This may help to reduce the granulation tissues.

Itching is experienced in healing area by most of the patients.

I hope this answers your queries and helps you further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. T Chandrakant (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (2 hours later)

Ok thanks doctor, ill do as advised.
i want to ask you also, do you know any good doctor/surgeon in dubai or abu dhabi whom i can see also for further advise? just for second opinion other than my current doctor.

Follow up: Dr. T Chandrakant (0 minute later)

Follow up: Dr. T Chandrakant (32 minutes later)

Doctor do you know about a treatment called KSHARASUTRA? is it effective in treating such condition? there seems to be success in it from online publications.

Follow up: Dr. T Chandrakant (0 minute later)

Doctor do you know about a treatment called KSHARASUTRA? is it effective in treating such condition? there seems to be success in it from online publications.

Answered by Dr. T Chandrakant (1 hour later)

Brief Answer:
Kshar-sutra is for fistula in ano

Detailed Answer:
Ksharsutra is done in Fistula-in-ano cases only. Not needed in your case.
I am sorry, I really do not know any surgeon or Doctors in Dubai or Abu Dhabi.
You may please consult our office as they can help you in this regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. T Chandrakant (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (2 days later)

Hi Doctor, i wanted to share with you an ultrasound report which i did today and want to know your opinion on it please. they did an ultrasound on the wound and little bit further downwards. i dont have any images yet.
Report finding was as follows:

"***ULTRASOUND SOFT TISSUE (lower middle scrotum)****
Irregular shape fibrotic changes and subcutaneous tissue swelling is seen in the base of
middle scrotum on the posterior part suggesting residual fibrotic changes but by this
exam normal signs of localized abscess or inflammatory collections."

does this mean that there is still infection inside?

Follow up: Dr. T Chandrakant (0 minute later)

Follow up: Dr. T Chandrakant (33 minutes later)

The doctor who performed the Ultrasound said it is normal inflammation that should subside with time.

Follow up: Dr. T Chandrakant (0 minute later)

The doctor who performed the Ultrasound said it is normal inflammation that should subside with time.

Answered by Dr. T Chandrakant (7 hours later)

Brief Answer:
If only inflammation - it will subside

Detailed Answer:
Great to know.
The report looks to be incomplete as the sentence is incomplete and not coherent > but by this exam normal signs of localized abscess or inflammatory collections."............
Since the Doctor performing the Ultrasound said - it is normal inflammation that should subside with time - means there is no collection as I can infer.
Please post the report ....

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. T Chandrakant (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. T Chandrakant (59 minutes later)

I attached the report, it only mentions what i wrote. Maybe the grammer was not correct. I asked them for the Ultrasound images so i can share them with you as well. the report didnt mention any sinus tracts or tunnelling, would they normally show in a Ultrasound?

Follow up: Dr. T Chandrakant (0 minute later)

Answered by Dr. T Chandrakant (5 minutes later)

Brief Answer:
Sinuses or collection can be seen in an Ultrasound

Detailed Answer:
Abscess or an collection is well visualized by ultrasound.
It seems that the Radiologist wanted to say something additional - most probably > are not seen or so .... just a guess. The Radiologist can tell us more.
The report is mentioning about scar and edema only,.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. T Chandrakant (0 minute later)

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar