Hi folks,

I’m kinda at a dead end in trying to help my father sort out an issue with his leg: 70-odd years ago as a small boy he was badly burnt in a fire. Luckily for him they lived very close to a wartime airbase and the doctors had got fairly good at using skin grafts to help heal major burns, so his leg and arm were saved.

It’s now 70 years later and the very thin skin graft on his shin is getting thinner to the point where it fails if there’s any trauma to it at all (even brushing against a table leg splits it). Once damaged it takes months to heal (6 so far with the latest injury). The result is that a previously active man is confined to his home – it’s affecting the rest of him physically and mentally.

The trouble is, the local medical team only seem to be able to treat it as if it were an open sore, as per the usual elderly maladies. This may of course be the correct treatment, but since it’s located on already damaged skin and not infected I can’t help feel there should be a different approach. For instance, each time a dressing is removed it takes some more of the previous skin with it and effectively make the wound worse.

He’s currently seriously contemplating a selective amputation as a way of dealing with this.

Does anyone have any ideas or experience with this sort of thing? Any thoughts or ideas of where we could find any advice or further treatments would be gratefully received.

Thanks,
BOAS

local tissue viability nurse/service?

GP should be able to refer if repeated would issues?

DrP

Ok – thanks Dr P – I’ll check that he’s been. The surgery he’s with is a country practice and I suspect they try to deal with things locally.

Ben

From good authority:

The current nurses will be treating it as a ‘normal’ wound, which it is not.

It needs the intervention of Plastic Surgey (consultant) as it is a complex skin issue. Plastics need to decide what the best intervention is, which may ultimately be amputation, however they need to explore possibilities, something that the nurse treating as a wound is not doing.

Appointment asap with GP, and explain back ground and ask for referral to plastics. If you get no where fast, may be worth paying for private plastics consultation.

Advice has come from someone who see this fairly regularly !

70-odd years ago as a small boy he was badly burnt in a fire. Luckily for him they lived very close to a wartime airbase and the doctors had got fairly good at using skin grafts to help heal major burns, so his leg and arm were saved

My grandfather had a face thanks to the efforts of McIndoe and his team of brilliant surgeons. He was in a plane crash (Rapide) but he went back in to drag people out. McIndoe and team fixed him. It was a continuous thing, with lots of little operations, but the surgery gave him a face, gave me a grandfather. Now, my father is benefiting from the new advances in reconstructive surgery after a bout of cancer.

I can only wish you well in your search here, and praise the brilliant work that reconstructive plastic surgery can deliver, and the life changing results that can come of it.

Thank you Funkydunc – I have been speaking to him tonight and said that although it’s nice having a local surgery etc, he needs to get referrals underway; firstly getting to the tissue viability nurse and secondly to the plastics. He’s having a Doppler examination soon so hopefully we’re on the way (after 6 months 😕 )

CFH: Couldnt agree more, my father has had at least 70 years of full life as a result of an early (possibly developmental) graft which is incredible given he technology of the time.

If he is not in a rush, then wait and see the TVN. However might as well get in the system asap. TVN will put him in to the same process and may as well start sooner rather than later