Hi, catra121:

Quote: "Clean it out using alcohol (rubbing alcohol that you can get in the pharmacy)."

The pharmacies in French Polynesia sell different kinds of rubbing alcohol. How many degrees should the rubbing alcohol mentioned by your boyfriend have? 40°? 50°? 60°? 70°? More? Or does it not matter how many degrees this rubbing alcohol has? The pharmacies in French Polynesia also sell non-stinging rubbing alcohol, which smells a lot like mentholatum. I do not know if this is a good idea to use non-stinging rubbing alcohol or if it is better to use stinging rubbing alcohol. I understand it will be painful to use stinging rubbing alcohol on my scraped knee wound, but the most important thing to me is that my wound heals, no matter how much pain I have to endure with the stinging rubbing alcohol.

Quote: "Do this several times a day...as often as the gauze is full."

First, I disinfect my scraped knee wound: I will, from now on, use the rubbing alcohol your boyfriend talked about. By the way, I do not know if this is a good idea to wash my wound with some soap and rinse it well, before I start disinfecting it.

Second, I apply on my wound the Flammazine cream (a white hydrophilic cream, containing silver sulphadiazine) the Emergency Room doctor prescribed for me. I use a thick layer of cream, just like this doctor did.

Third, I apply six 10 centimeters X 10 centimeters non-woven gauze pads on my wound, just like the Emergency Room doctor did. I guess she decided to use that many gauze pads to try preventing or avoiding the pus crossing all the layers of gauze pads (if there are too few of them) and staining my clothes or bed sheets.

Fourth, I use two small pieces of tape to keep the first two gauze pads in place. Then I can put the four other gauze pads on top of the first two.

Fifth, I use a gauze bandage, to wrap around my knee and over the six gauze pads, including the first two that are taped to my skin.

Sixth, I use another type of bandage (not an ACE bandage; I do not know the name of this bandage in English).

Seventh, I use a kind of "net", whose exact name I do not know, to hold the dressing in place.

Last, I put on my functional knee brace, whose bending is locked at 40°. It hurts my unhealed and infected scraped knee wound, when I bend my knee more then 40°.

These are the problems with my scraped knee wound at the present time:
-Redness around my scraped knee wound
-Large amount of pus, thick and yellowish, coming out of my wound (this amount of pus is so large it sometimes crosses most, if not all, the six gauze pads of my dressing; this amount of pus also happens to cross the gauze bandage and the other bandage from time to time)
-Foul odor, like that of a dirty baby diaper, coming out of my wound
-Burning and throbbing pain in my wound
-Small amount of liquid, with the consistency and color of cooking oil, leaking from my wound after its disinfection, after my wound is left uncovered at night for an hour or two, before I make a new dressing for my wound
-No new skin or scab growing or even starting to grow over my wound
-The time that has gone by since my knee got scraped on February 10, 2012

All these problems make me fear it is not an "ordinary infection". It might very well be (and I believe it is) a MRSA infection. Of course, I have yet to find a doctor who will believe me. Hard, very hard task! These doctors would believe me first if I told them the sky is green, before even thinking of believing I have an infection in my scraped knee wound. No wonder I have lost trust in all doctors!

Quote: "He said to try to pack the wound if it's deep to draw out more of the pus."

Under my scraped knee wound, there might be a large "pocket" of pus, for all I know. There is no way for me to tell for sure. I think it is quite likely, however, because one of the last times I had a bad wound on this knee (post-operative wound from my November 2004 Anterior Cruciate Ligament reconstruction), this wound leaked pus for months, even though this wound seemed to be closed and even though the amount of pus that leaked from this surgical wound was less than the amount of pus that is leaking from my scraped knee wound.

Quote: "He said you can use neosporin on it...but the alcohol should be sufficient in most cases and may make it easier to gauge how much pus there is vs cream."

Can I not use rubbing alcohol first, to disinfect my wound, and then neosporin, once the rubbing alcohol had dried?

Thank you for your information and thank your boyfriend also for me for the information he provided. It gives me back hope and I do not have to spend my time crying a lot anymore.

Sorry I didn't get back to you sooner...my boyfriend worked the closing shift last night so didn't get home until around midnight and I wanted to check with him before responding. He uses the 70% rubbing alcohol...and neither one of us is sure about whether the non stinging stuff would be as good (though we don't necessarily have any reason to think it wouldn't be). The idea here is just to get it really cleaned out and disinfected.

As for the neosporin cream...you could use some after the rubbing alcohol has dried if you want to...using a cream might even feel soothing after cleaning it out with the rubbing alcohol. That's really just up to you.

From the sounds of it...we both think maybe you should try cleaning it out more times during the day. You didn't mention how many times you go through the process of cleaning it out and bandaging it but it should probably be every 6-8 hours...more if it's seeping through the gauze even at those intervals. Cleaning it out more often may mean you can use "less" gauze.

He also wanted to add that if you are able to soak your knee in warm water (like a warm bath) then that could help to draw out more of the pus too.

A way that they sometimes track whether the infection is getting better here is to draw a cirlce around the red area surrounding the wound with a pen or marker and then track whether that redness is getting bigger than the circle or if it starts getting smaller. I don't know if you can do this given how sensitive the area is...but if you can it might give you a sense of whether it is getting better or worse.

Hope these things help. A bad infection can take a few weeks to heal and it's actually better for you if the wound hasn't healed because it will be easier to drain the infection than if the scrape had scabbed over. Then you would have to lance it to get it drained and I cannot imagine how painful that would be in an area where you have RSD.

Hi, catra121:

One last thing I forgot to mention (aah! my bad memory again!) is that when I change my dressings, I throw away the old one in a small trash can. Guess what I noticed about 24 hours later!? (I had not payed attention to this potentially happening before; I had not even thought this could happen.) I noticed this part of my old dressing, the gauze pads whose centers were soaked in pus and had just a little bit of Flammazine cream left on them, had been eaten, YES, eaten by some little ants. Can you believe this!? Only the parts of my gauze pads with no pus and cream on them had not been eaten by these ants. How disgusting these ants are! Really!

I also noticed that these small ants were walking up along my left injured leg, biting it painfully here and there. Because of my RSD, these bites feel like burning bee stings. After what happened with the pus-soaked gauze pads in the trash can, my guess is that these ants are trying really hard to find a way to my pus-filled scraped knee wound to bite it (owww! owww! ) and eat all the pus they can (gross! ) This is one of the reasons why I use two bandages: the gauze bandage and the other one, whose name I do not know in English. I am trying my best to keep these ants off my wound, but I have the bad (and angry) feeling they are trying to find (and will succeed in finding) a way under my dressing to get to my wound, bite it, and eat the pus. I really, really do not understand how ants could be interested in eating pus. It most certainly does not taste good! If these ants absolutely want to get to my wound, which has not shown any sign of growing new skin, closing up, and healing, these ants just have to eat a very small part of the bandages and gauze pads; if they wanted to, nothing would prevent them from doing so.

Catra, you do not have to apologize; I know you and your boyfriend have a life of your own that keeps you busy. It is normal. You are both already being soo kind and compassionate when you respond to my messages, to give me information and comfort. I can assure you that I appreciate this. What would I do without you!? I know without the shadow of a doubt that you are doing the best you can. I will forever be grateful for what you are doing for me. You are both helping me soo, soo much more than my primary care physician and other doctors. I will never, ever forget this. Thank you very, very much.

Quote: "He uses the 70% rubbing alcohol...and neither one of us is sure about whether the non stinging stuff would be as good (though we don't necessarily have any reason to think it wouldn't be). The idea here is just to get it really cleaned out and disinfected."

I will buy the 70% stinging rubbing alcohol, because this is the one your boyfriend uses. Since it really worked on him, it should work on me also. When I think about the non-stinging rubbing alcohol, I am not so sure it will work at all, so I will not take any chances with using it. I will use the stinging rubbing alcohol, so I am at least sure it will work.

I will do just as you suggested, using the neosporin cream after the rubbing alcohol has dried.

Quote: "Using a cream might even feel soothing after cleaning it out with the rubbing alcohol."

This gives me even more reason to use this cream.

Quote: "You didn't mention how many times you go through the process of cleaning it out and bandaging it but it should probably be every 6-8 hours...more if it's seeping through the gauze even at those intervals. Cleaning it out more often may mean you can use "less" gauze."

From Mondays to Fridays, I work as a secretary-archivist in the garage where I had my work injury. I leave home for work at about 5:30 AM and I get home after work at about 5 PM. This gives me enough time to do, at home, in the evening, only one dressing daily, from Mondays to Fridays. This does not apply if one of these days is a vacation day. I could make more dressings at my workplace, but I would then have to take an extra large first aid kit, will all the necessary stuff inside. However, there is no bathroom in the garage for female employees, but there is a bathroom for male employees (especially for the mechanics who get dirty after taking care of cars in the garage). Female employees cannot use the male bathroom because it has no door to protect thr privacy of the female employees. Besides that, I am not sure at all my boss would appreciate my taking some time off work to do my dressings, even if the scraped knee wound was a work injury.

On Saturdays and Sundays, I can do more dressings, with my two-year-old baby boy looking on with lots of interest. He points at my old dressing, still on my injured knee, and asks me: "Do you hurt?" Since I hate lying to my son, I tell him the truth and I reply: "Yes, it hurts, but I will take medication to make the pain stop." He asks me a lot of questions, such as: "What is this? What are you doing? Why are you doing this?" Even if he may not understand all my answers, I do my best to help him understand, so he does not get scared or is less scared when he sees me crying. My child unfortunately knows, at his very young age, a lot about the medical world: he has spent more of his two years of life in the hospital than out of the hospital, because of his cystic fibrosis, the complications of this disease, all the transplants (one heart, two lungs, two kidneys), the recovery from surgery, the physical therapy, the hospitalizations for exams or for illnesses that could kill him, although harmless for another child (such as the flu).

Quote: "He also wanted to add that if you are able to soak your knee in warm water (like a warm bath) then that could help to draw out more of the pus too."

I will go to a store to look for a large enough plastic basin, which could be filled with warm water. Then I could sit in this basin and let my injured knee soak in this warm water. I guess I would have to do this until the water gets cold. After throwing the dirty, cold water away, I could wash the basin with some soap, fill it with some warm water again, and soak my knee by sitting in the basin again. No house in French Polynesia has bathtubs in them, which I find strange.

Quote: "A way that they sometimes track whether the infection is getting better here is to draw a circle around the red area surrounding the wound with a pen or marker and then track whether that redness is getting bigger than the circle or if it starts getting smaller. I don't know if you can do this given how sensitive the area is...but if you can it might give you a sense of whether it is getting better or worse."

This is a very good idea. I will use a permanent marker, like orthopedic surgeons when they mark the different areas of the knee, as well as the area(s) they are going to operate on. As for the pain and the sensitivity of the area of the scraped knee wound, I will stand the pain if it helps me tell if the infection (redness) is getting better or worse.

Quote: "It's actually better for you if the wound hasn't healed because it will be easier to drain the infection than if the scrape had scabbed over. Then you would have to lance it to get it drained and I cannot imagine how painful that would be in an area where you have RSD."

If my scraped knee wound has started to scab over or has completely scabbed over, I might think the infection has healed when, in fact, it has not. If a scab is present over the wound, apart eventually from the redness around it and the throbbing pain, how could I tell the wound is still infected? I guess the pus could not leak anymore if there is a scab over the wound.

Removing the scab would be nearly impossible, unless a local anesthesia was done (how very painful in an RSD area). I do not see my primary care physician accepting to do this, considering he does not believe in the infection, like I mentioned it in my previous messages.

As for draining the infection with a lance (do you mean a syringe with a needle?), I believe I would pass out from very strong fear before the doctor (dermatologist or orthopedic surgeon) even had the time to start draining the pus with his syringe and needle. I would think the doctor would have to drain the infection several times, especially if the pus keeps on "coming" again and again, after each drainage was done.

I thank you and your boyfriend very, very much. I got from you both much, much more information and help than from my doctors and Internet web sites. You are the best!