Patient's Query
Hello doctor,
My infected sebaceous cyst has burst 10 days back and daily dressing is being done by professional. I was on antibiotics but the course is over. What should I do next?
I do not want to go to the hospital and get the surgery done.
Since more than ten years two cyst was there and of late it merged into one. May be in the second week of last month, I started getting an itching sensation and the place becoming red and after a few days it burst. Since then regularly it is being dressed with the removal of pus. It has created a deep hole.
Please help.
Thank you.
Hello,
Welcome to icliniq.com.
Do not worry, I will solve your problem. The probable diagnosis is a ruptured cyst. Wound healing is a very common problem in diabetic and hypertensive patients. Even when they are controlled, I will advise you on treatment with some basic precautions and investigations. Check your blood sugar levels regularly and also do an HbA1c (glycated hemoglobin) test.
Pus is still present, so an additional five days of antibiotic treatment are required. I will advise you on some dressing spray to heal early. Wound dressing with removal of pus and black margin is essential every day.
Treatment:
Tab Zifi (Cefixime) 200 mg BD for five days, Chymoral plus (Trypsin-Chymotrypsin) twice daily for three days, Limcee (Vitamin C) for 10 days, capsule A to Z (multivitamin) for 10 days.
I hope this helps.
Thank you.
Patient's Query
Thank you doctor,
I am tightly controlling diabetes with a regular dose of Insugen 20 unit in the morning and night, Apidra 20 unit in the morning and night. Humalog and/or Novarapid as when required because as soon as my sugar count goes beyond 150, I get an itching sensation on ear cartilages, at that time I take about 10 units of either.
In this lockdown, I do not wish to go to any pathologist. I try to maintain my HbA1c under 7.2. I have not understood what the black margin is. Please advise whether I should keep wound open or covered.
Please help.
Thank you.
Hi,
Welcome back to icliniq.com.
Two most important things for wound healing are:
1. Tight blood control.
2. Wound care.
You are monitoring your sugar levels that is good. Try to keep HbA1c below 6.5. Wound margin means corners of the hole of the wound that is the area between normal skin and hole. Also, the dressing should be done aggressively and not with a soft hand. Rub that area of wound and in the hole aggressively so the wound will heal early. No issue with drinking if in control way. Please get back to me after five days.
I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thank you for your reply.
I would like to show you the latest development of the wound and request your guidance on any mistakes we may be making. The professional nurse does the dressing every alternate day, so it was not done yesterday, and today it was done. The condition and management of the wound are depicted in the attached file. Please guide as in the first two pictures of the wound.
Please help.
Thank you.
Hello,
Welcome back to icliniq.com.
Now the wound is healthier than before. Good job on your knowledge. I want to share something with you. A wound with red color with active bleeding is healthier than a dry wound with a yellow tinge and discharge. Now your wound looks healthier, so keep it up. It will heal soon. Remember my previous comments: alternative day dressing is sufficient, and stop all medication when the dose has been completed.
I hope this helps.
Thank you.
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