Brief Answer:
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Detailed Answer:
Hello XXXXXXX

I am sorry you are having so much pain and problem getting your wound to heal. It sounds as though you are taking care to keep it clean as best as you can.

This wound needs to be evaluated in person to assess the cause of the wound. Do you have diabetes? If not has your sugar been checked recently?

Do you have varicose veins? Do you have any heart problems that might cause leg swelling?

I recommend that you go in to be seen by a dermatologist if none of the above are considerations. If you do have diabetes, then your endocrinologist would be the place to go.

Venous stasis, which is where the blood doesn't return properly from the lower legs because the valves of the veins are stretched from varicosities, can cause swelling in the lower legs, and over time there can be skin changes and skin break down. That may be the problem, although I can't tell without examination and knowing your medical history. Treatment is prescription strength support stockings to prevent the fluid accumulation. The wound is treated with a special gauze that is impregnated with medicine such as Dome's paste, or other preparations, and rechecked frequently to make sure it is healing.

Heart problems and high blood pressure can also cause fluid accumulation in the lower legs and the thing to do is to treat the underlying problem and also take a diuretic to remove excess fluid.

Diabetes can cause vascular insufficiency and delayed wound healing. So get a fasting blood sugar test and also an A1C blood test.

There may also be an infection of the soft tissue of the wound, and this should be cultured to see what might be going on.

So, although it sounds like you have been doing your best to care for this wound, it is time to go in to be seen and have it evaluated.

I hope this information helps. Please let me know if I can provide further information.

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