Hi all,
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Firstly please allow me to apologise for the long post.
I have a question, I have a patient who came to see me with a large VP on the left foot, lateral arch. This person was in a fair amount of pain and said she needed this dealt with quickly as she needed to attend her daughters wedding in 3 weeks. This lady only takes diuretics p.r.n to deal with the occasional fluid retention. Health wise all fine. A week later I perform the needling under aseptic techniques, bearing in mind this is not the first needling I have performed, as I have a large number of these without issues in the past. Px comes to see me 3 days post needling. No issues apart from some discomfort, which is not unusal. The usual advice is given to the px and is asked to return after eschar has fallen off or if she has an issue. 4 weeks later Px calls me says is in severe pain she had had to attend a&e where doctors Rx'd antibiotics for prophylactic reasons, but couldn't see much wrong. I asked her to come in, she had a large area of dry sloughing, px was in pain but no signs of infection, foot was the same temp and colour as the other foot, she had pain +++, but as this px insisted that she did not want the eschar touched, I suggested she buy some intrasite or similar agent use this daily and see me in a week. A week later she calls back saying she had to go back to a&e where the doctor removed the eschar under l.a. and saif she had a massive infection. She is now attending a&e for dressings. Does anyone have any experience or heard of something similar, as this has never happened to me before??
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