Brief Answer:
Please give few more details and post/upload actual photographs if possible.

Detailed Answer:
Hi.
Thanks for your query.

To recapitulate: Male/81 - very large egg sized swelling on left heel - 3+ pitting edema - soaking in Epsom salts - wants to know what to put on the sore - no vascular insufficiency - sees Vascular Surgeon every 3 months ....

Having egg sized swelling on the heel with pitting edema is a big concern.
We have to know the cause and get an appropriate treatment.

The most probable cause can be :
- An abscess with spread up swelling in all directions.

Hence I would advise you both the following:
- Consult a Doctor, may be in ER or a General Surgeon preferably to get a confirmed diagnosis and investigations as advised , so that a proper treatment can be instituted.

- Elevate the leg above heart level in laying down position to reduce the edema and pain.
- Give him anti-inflammatory medicine whichever suits like Ibuprofen 400 mg after some food.
- Will need an antibiotic and surgical drainage if abscess is suspected.

Please give detailed history:

- Since when is the swelling present?
- Is there throbbing or such pains?
- Which area is affected by pitting edema?
- Any other medical condition like diabetes?

Please post/upload a clear and focused photograph as it helps sometimes for on-the-spot diagnosis.
You can upload it at the reports section.

Regards

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Brief Answer:
Pursue him to attend ER to avoid further complications

Detailed Answer:
You are most welcome.
Seemingly a large blister on top of swelling is indicative of an underlying abscess and if present needs a timely incision and drainage.
Please pursue him to attend ER to get an early and proper diagnosis and proper treatment with antibiotic, incision and drainage if required after appropriate investigations to avoid further complications.

I hope this answer helps you for an early and proper diagnosis and treatment.

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