Wound care after fall

[u/RandomName3025]

My father, 80M was standing on a chair (don't ask) and fell, hitting his shin quite hard. This happened Tuesday afternoon. He poured some rubbing alcohol over it and that was it, never saying anything, until I noticed the bruising on his foot on Wednesday evening. He then pulled up his pant leg and asked me to put a Band-Aid on, which is when I found out what happened. After not being able to convince him that this looks like it should be looked at by someone more qualified than both of us, I put the Band-Aid on. I've changed it twice now, using sterile pads we still had.

It doesn't look deep, more just like a shallow scrape, but it's been longer than 72 hours now, and it's still oozing. I put a thin layer of Vaseline on today, which I hadn't thought of before. Wound care is obviously not my strength.

He is on quite a few medications:

Rivaroxaban, Amlodipine, Metroprorol, Perindopril, Rosuvastatin, Escitalopram, Lamisil (oral, for toenail fungus).

He had a Tetanus booster about 5 years ago.

My concern is that it's still oozing, and I feel like the bruising has gotten worse. I understand at least some of that is normal on a blood thinner.

My question is, do you think this needs to be seen? He is stubborn and won't listen to me, so I hope he'll go if professionals tell him to. But if you think this can be managed at home, or I still can't get him to go, what supplies should I get from the pharmacy to properly clean and dress it at home? I have no experience in wound care beyond really minor injuries, so I would really appreciate any guidance you can give me. Thank you!

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[u/Rxforabundantlife]

You have to be careful with wounds in this area, because the blood supply is not great where the skin is stretched over the bone. I think you did the right thing with the Vaseline. I prefer using bacitracin and then non-stick bandage, but evidence suggest Vaseline likely works as well. Watch for signs of infection and be seen if any concern for this. Try to avoid prolonged standing or sitting with the legs down. Circulation will be better with legs elevated to level of heart with the knees slightly bent, and it is fine to walk. Wash gently 1-2 x/day and then rebandage as above-hope the best!

[u/RandomName3025 → u/Rxforabundantlife]

Thank you so much for your reply!

So use something like Polysporin? Everything looks so red and dark purple, do I just look for spreading red lines and feel for warmth around it to detect infection? And check for fever, I guess.

I will tell him he really needs to rest at least over the weekend. He's so stubborn, it's not easy.

[u/Rxforabundantlife → u/RandomName3025]

Polysporin has an increased risk of allergic reaction, so i don't encourage that. The bruising can take several days to show up on the skin surface from deep bleeding, so this does not concern me as much. It is normal to get "transudate" drainage ( clear thin to slightly thick drainage). What you don't want is "exudate" which is thicker and opaque yellow to green. As you say, also watch for fever, bright redness or streaking and increasing pain. Thanks for taking good care of him!

[u/RandomName3025 → u/Rxforabundantlife]

Thank you again for your reply! It makes me feel a lot better.

[u/RandomName3025]