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Pain-Killing Ointment For Wounds

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bainbrig | 15:42 Wed 08th Aug 2018 | Body & Soul
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I have a small open wound (technically an ulcer). Because of its position, it hurts.

I can't really use Voltarol (ibuprofren gel) or similar, because it IS open.

Are there any pain-killing ointments which are okay to put on such open wounds?

Ta.

BillB

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"I have a small open wound (technically an ulcer)."

Where is it and how long have you had it?

I know of no analgesic creams suitable for an ulcer. If the pain is due to an infection, then you will need an antibiotic cream.
Question Author
I am an amputee.

I get occasional small, unimportant pimples on my stump - it's covered with a 'liner' all the time, nice and warm and a little damp, good breeding ground.

Mostly, the pimples come, and go. Occasionally (like this one) they are in unfortunate positions - on the skin right on the head of my fibula - which means it sits precisely between bone and hard prosthetic socket.

I'm dressing it with Comfeel (an ulcer dressing) which is effective, and it is getting smaller, but in the meantime it hurts (whenever I have my leg on).

Answer is (of course) to have my leg off for the next few weeks. Not possible or practical.

So I was hoping for some pain relief in the interim.

Maybe just paracetamols will find their way to the appropriate spot.

BillB

Difficult....very difficult and i am afraid that i am not your man for an answer.
There are a couple of nurses on AB and Woofgang who is an occupational therapist who would be of better value to you.
Question Author
Thanks for trying, Sqad. Occupational hazard of being an amputee, I’m afraid.
Your pharmacist and/ or practice nurse at gp's will give you advice.
bainbrig, stump care was never a speciality of mine, but I know a little of the basics of wound care and pressure area care. Have you had advice from a pressure area skin care specialist? Because their current advice would obviously trump my older comments. If the wound is not infected and you want to use your prosthesis, then you need pressure relief to relieve the pain and this would usually consist of specialist dressings and or padding the area around the wound to relieve pressure and friction on the wound itself. Unless the skin is calloused or the wound needs to be made to heal slowly from the bottom to prevent a pocket of unhealed flesh being skinned over then I would not add any kind of ointment as this will make the wound area and surrounding skin damp and more fragile.
The other need of course is to have the skin cooler and drier for as long as possible which would involve spending as much time as you can time without your prosthesis and liner to get air to the skin which I know can be very difficult, especially with the weather as it is.
Anyway there's my advice for what its worth.
Question Author
Fair comment, Woofg. Pressure relief is a non-starter - it’s LESS pressure it needs. In fact I take off stump socks to lessen the socket-pimple-fibula sandwich. This helps.

Prosthetist is making a new leg with built-in relief at the fib head, so fingers crossed for that.

At least it’s cooler..
BB
Bill, pressure relief does mean less pressure. The concept is that to get pressure off a wound and whatever is pressing/rubbing against it (relieve the pressure) you build up very slightly the area around the wound so the surrounding healthy skin temporarily takes the weight off the wound.....like a doughnut cushion to relieve piles :) Are you being seen by a pressure care specialist?
Question Author
Not specifically.

Tissue Clinic - very good for the actual dressing end.

Prosthetist at RNOH Stanmore.

The latter is making the ‘bulge’ on my socket deeper (where the fib head goes).

I’ll look into the corn plaster (ring) idea - might help.
Ask the tissue clinic if they can suggest something...DON't use chiropodist felt rings or anything similar. I am quite surprised that they aren't making suggestions themselves. Do they know how much pain you are in?
Question Author
Why not chiropody adhesive felt?
Stanmore are the gold standard in Uk prosthetics. The department used to be heavily staffed by people who had had polio and therefore had a vested interest in producing the best orthoses that they could. When I was in clinical practice there in 1971, many of the older staff were still orthosis users and most of them were happy to talk about design and development and how it actually felt to use one.
because its designed to be used on tough foot skin and not on the more fragile skin of a stump. Please please get advice from your tissue care people.
Question Author
Well, Stanmore Prosthetics has been farmed out to Blatchfords, a private company - they’re still good, but so severely understaffed that there are many problems.

Re the felt - don’t forget this sore bit is on the side of my knee (BKA amp), not on the base. But if I can get a word with the tissue nurse I will.
I understand that but am guessing that the skin feels soft to the touch? not like the skin of a foot? The constant moisture and cover will keep it moisturised and exfoliated and that is not the kind of skin that chiropody felt is designed for. The felt is also not very compressible so instead of compressing and releasing as your weight shifts, it will press into your healthy skin and may make matters worse.
Question Author
Thanks for the input, Woofg. I haven't had much of that over the years from Stanmore or similar (in fact the so-called consultant recommended Dermol for a stump ulcer...)

Since I've played with the stump socks (i.e. wearing fewer than normal) I have relieved the pressure and it feels much better.

BillB
always happy to help if I can :)

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