Looking for leak dressing advice

#1
So it's a challenging area to work with alone.. I'm finding that out :-(

I've been using these gauze pads & medical tape but it isn't really covering the specific area I need it to so I usually end up stuffing a few tissues in with it to supplement the soak so to speak :)

I know I'm essentially wasting the gauze pads at this point since the draining is no longer significant but I'm not really sure what to use.

Those little sort of match book size gauze squares might not be big enough..

I suppose liquid bandage isn't advisable either since that'd likely stop any draining..

I just joined.. just started having issues so I'll probably make a post of my story to date & do a picture thread too.. 'cause I know we all can't get enough of these gnarly pictures.. at least everyone else's make me feel a little better about my own..

But for now my main concern is the dressing.. the bit of leaking isn't something I want on my clothes or more importantly potentially running down me as much as I can prevent it.
 
#2
Try Tegaderm! It's a flexible, leak-proof, thin adhesive sheet that goes straight over a piece of non-stick gauze on the wound and seals it off perfectly. I first had it in Dec 2016 during a lancing/packing and they gave me tons to take home bc it's so good. It made the whole wound-care portion soooo much better and easier to deal with. Now it's part of my permanent medicine kit.


When my area is actively draining, I use it to seal off a nice layer of non-stick gauze that catches the fluid. The Tegaderm acts like a flexible seal sheet to safely and comfortably adhere the whole thing down to the skin so it stays intact and dry even during bathing.


It can be found in pharmacies by 3M or Nexcare brands, or on Amazon. It's kind of pricey, but trust me, they are worth every single penny. I've even cut the sheets into strips to hold the gauze onto my skin around the edges of the gauze pad in order to save money. Really good stuff.
 
#3
Oh yeah that stuff looks great.. easier than the awful tape job I've been doing with medical tape.

What's it like to pull off to change ?

Before mine started training I tried liquid bandage too which I noticed would have been a mistake if it did drain since the fluid wouldn't have had anywhere to go.

Was just looking for some pain relief at that point 1st time I've had trouble & I wasn't entirely sure if it was a friction or pressure issue.
 
#4
It's much easier to remove than traditional tape (in my opinion). I get it a bit damp first and "roll" it off at the edge and peel away. It's very flexible (almost feels like a second-skin) and that's what makes it so good at sealing the edges. Much easier than medical tape.

Mine is still draining, so I had to run to the store to buy more supplies, and I actually just found a box of Nexcare Tegaderm *with** a pad of gauze in the middle - almost like a traditional band-aid. Saves a step - I'm getting ready to remove my old piece and put this new one on. No gauze needed, it appears.

When it comes to the pain relief aspect - I completely understand trying to figure out how to minimize that. I find that when my cyst is draining freely into a gauze pad and there's no friction/discomfort from tape it does help a lot.
 
#5
Mine is still draining, so I had to run to the store to buy more supplies, and I actually just found a box of Nexcare Tegaderm *with** a pad of gauze in the middle - almost like a traditional band-aid.
Like these: http://a.co/3MZIbzB or like these ? http://a.co/7ps1gpA

Did'ja get'm local from a CVS ? That's the only sort of supply store like that we have here.. no Walgreens. Granted CVS is probably the ideal place anyway.
 
#6
I actually found it in my local grocery store (Smith's/Kroger) in the regular band-aids/first aid aisle. I was in pain so I was trying to eliminate a second trip to another store - lucked out! I'm quite sure CVS carries it too.
 
#8
No, I have only had lancing/packing.

I'm looking into my surgery options, but it will probably still be a few years. I have a 6-year old daughter and now have a baby on the way, so I have to do it when I am able to have plenty of time to recuperate on my own without putting too much stress on our household needs. Usually my flareups are only once every few years (manageable) but with the pregnancy I've had 3 flareups just since October!! Ackkkk
 
#9
No, I have only had lancing/packing.

I'm looking into my surgery options, but it will probably still be a few years. I have a 6-year old daughter and now have a baby on the way, so I have to do it when I am able to have plenty of time to recuperate on my own without putting too much stress on our household needs. Usually my flareups are only once every few years (manageable) but with the pregnancy I've had 3 flareups just since October!! Ackkkk
I haven't had anything.. mine is still a smaller raised bump at the moment than it was when it first began.

Are you using the Tegaderm & everything with any size of bump or only once it's all completely drained bump wise & still weeping from the site ?

My only small concern is if I do use the Tegaderm with the gauze & the small bump remaining finally bursts.. well I guess all that mess being contained would be good just have to change it ASAP huh..

That was one mistake the liquid bandage would have been doesn't leave any option for drainage.. shouldn't have done that..

What are your lancings like ?

Is it what I see most people refer to as a "midline incision" then stitch ?
 
#10
I will be very honest, lancings are incredibly painful - but, as soon as it's over and the cyst is draining, it's not painful anymore.

The "midline incision and stitch" is part of a different procedure, one I've never had.

has your bump ever gotten hot/infected/swollen and then burst?

What happens during a lancing is this: when the bump is infected/abscess and ready to come to a head, they usually give an injection into the area with lidocaine to topically numb everything. Then they slice it open, push and prod till all the goo comes out, flush it out with saline solution, and then pack the wound with gauze Strip so that it will remain open to heal from the inside out.

At that point, it will keep draining, hence the need for gauze changings to keep up with the fluid. The packing usually stays inside the wound until your followup exam and they inspect it - then either take it out and let wound continue to heal or put more in if it needs more time.

To answer your question about the Tegaderm/liquid adhesive issue of stopping drainage - yeah you definitely want to use gauze when it's actively draining in order to catch the fluid, and the Tegaderm creates a nice seal *around* the edges of the gauze to reduce the chance of leakage. Unfortunately, the leakage smells gross and can stain clothes, so the less chance of contact with air the better. I learned that the Tegaderm really helped me keep everything as clean and leak-proof (and long-lasting) as possible, more than any other type of tape/adhesive.

So yes, if you already have your bump covered with gauze and Tegaderm and it bursts, it will absorb/catch the fluid. You will definitely know when it happens! Then you can change it as needed.

I understand your point of not wanting to seal in the fluid with liquid bandage and risk it not continuing to drain. You want gauze to catch/absorb the fluid but yet not prevent the flow.

I also always keep Betadine on- hand to swab the area with this liquid antiseptic in between gauze changes.

The bump does drain for quite a while, I've learned. I mean - 3 or more weeks is typical for me - but it does lessen with each week.

Believe it or not, the gauze change setup becomes super easy.

I just found some new gauze that I'm trying - also from the grocery store although I'm sure it's available everywhere - contains baking soda to help with odor. I'll report back with my results - so far, I do like it. A bit pricier, but figured what the heck, might as well see if I like it.
 
#11
I forgot to answer one of your questions - about whether I use Tegaderm and gauze with any size bump or just when it's draining. I only use it when I'm actively draining, either after a lancing or if it bursts on its own.

When I merely have the bump but no pain, I leave it with nothing on it, bc unless it's infected and about to burst, I see no point in fooling with it. I can always tell when it's time to get the gauze!
 
#12
I will be very honest, lancings are incredibly painful - but, as soon as it's over and the cyst is draining, it's not painful anymore.

has your bump ever gotten hot/infected/swollen and then burst?

What happens during a lancing is this: when the bump is infected/abscess and ready to come to a head, they usually give an injection into the area with lidocaine to topically numb everything. Then they slice it open, push and prod till all the goo comes out, flush it out with saline solution, and then pack the wound with gauze Strip so that it will remain open to heal from the inside out.

At that point, it will keep draining, hence the need for gauze changings to keep up with the fluid. The packing usually stays inside the wound until your followup exam and they inspect it - then either take it out and let wound continue to heal or put more in if it needs more time.
So I've only seen a nurse practitioner thus far & I'm not about to let her go all leatherface with my bumps & lumps..

She also suggested a small scalpel too would be what she would use if we were to go that route.

Which makes me wonder.. why a scalpel ?

Why not a little hole with a little needle ? Seems like far less a commitment in terms of invasive-ness & far less large of a hole.

What do you attribute the incredible pain to during lancing if they attempt to numb some with lidocaine ?

The incision itself ? The squeezing ?

Obviously it's in a pretty sensitive area too but I've watched some random popping & draining videos on Youtube just because it's kind of interesting & strangely satisfying to see it all resolved.

But those were not this either.. granted they were cysts & often times worse things than pimples but I notice in most of the videos they shoot quite a bit of numbing all around the area..

Is it a general surgeon that does yours ? Dermatologist ? Or have you located yourself someone Colorectal in your area at this point of dealing with it for awhile ?

My bump started out pretty angry about 2 weeks ago now.. the NP did say looks infected.. swollen.. strange thing is it did burst a bunch when I started taking the antibiotics.. but not completely..

I noticed some stuff that resembled mucus from blowing your nose had came out of it.. & oddly enough I've never noticed a smell from anything draining out from it & I've certainly checked much as I didn't want to..

The portion that did burst did so one day when I got out of the car.. I remember the moist feeling from the fluid & the relief from the pressure..

But still this small bump remains.. no pain.. wouldn't even know it was there if I didn't know it was there..

I don't have a great deal of confidence in this NP & the poor person's clinic I've been going to so.. I may have to see about visiting a dermatologist too but even then.. I feel like they're just going to say yup.. cyst.. need to drain it..

Which is what I hear all the horror stories from most people about.. the whole "I've dealt with this for 6 years & I wish I'd have gone straight to a colorectal / found this site & its recommended doctors & procedures" so I'm apprehensive about doing anything but that..

But then again it's not like the dermatologist won't share their observations.. make their recommendations & I could go from there either.. & it would make me feel better than the opinions of a few NPs.

Baking soda gauze huh.. sounds neat :)

I do still find it shocking I didn't notice a scent to any of what has been leaking out of me.. & there hasn't been anything recently.

Is Betadine similar to Hibiclens ?
 
#14
I go to either my local urgent care or in my most recent case, the hospital ER bc I'm pregnant and they put monitors on for my baby's heartbeat to ensure her safety. I actually majorly lucked out in 2016, the doctor in urgent care who did my lancing that time actually suffered from pilonidal cysts himself so really knew what he was doing. (He gave me a referral to the best specialist in my city for the surgery, but the timing hasn't been right just yet). He taught me how to do the gauze/Tegaderm system and I learned so much from him both medically and personally through his own experience.

Ok, so on to the lancing. I've only had mine lanced when the bump is already at maximum-level abscess/infection and therefore swollen, painful and I already can't sit or stand. So to have someone inject that most painful part of my body with a needle is like YYYYYIKES!!!! Ouch!!!!!! And then the pressure of them pushing and squeezing all of the fluid out is pretty bad. I have a high tolerance for pain, but damn if I didn't practically crumple the bed rails into a ball with my bare hands. They would always apologize so profusely, knowing how painful it must be, and I would reassure them that it's ok because I do understand it's what's needed in order to be very thorough.

As for the scalpel, that part doesn't hurt. They use a scalpel to lance bc flat skin cuts heal better than a hole. So a super sharp, flat slice through infected skin will drain more thoroughly and come back together much more successfully than a punctured hole. It also helps the fluid come out cleanly, rather than squirt.

All 3 times I've been lanced, they've also packed the wound with this thin, almost shoelace-looking length of gauze that is designed to hold the cavity open so it can heal from the inside out. Mine is 4cm
Wide, 3cm deep. Having someone stuffing gauze INTO the newly-emptied hole is pretty damn painful too. So it's just a lot of activity in an area that is already really super painful just on its own.

BUT - all that said, as soon as that was done and the gauze is on and I'm headed home, it's all good, no pain anymore, just wound-care management at that point no big deal.

I'm glad you don't have any odor issues with your drainage - yours simply may not be as highly infected as mine have been and that is obviously a good thing. Plus I'm super sensitive to smell in general, even more so now that I'm pregnant - so that may just be a "me" thing right now.

To answer your question about Betadine, no, it's different from Hibiclens. Hibiclens is a lightly-foaming soap for cleaning up with water (good stuff!!) but Betadine is povidone/iodine-based antiseptic liquid that's swabbed onto the skin to handle or prevent infection. It's dark-brown in the bottle and goes onto the skin the color dark yellow - if you ever see surgeries it's that dark yellow liquid they swab all over prior to surgery. Every doctor I've ever gone to has used it - and I always inspect whatever supplies the doctor uses so I can purchase it myself to have on hand. Been using it for decades. It's at CVS.
 
#15
Also, about dermatologists / I see your point and agree that they may just point you toward another doctor and create an extra step.

I've had good luck with my lancings in that the first one was done at an ER, so all-around doctor that knew what he was doing. Second one was my Hero of a doctor who I lucked out with randomly at Urgent Care, who had his own personal experience with pilonidal cyst. (I will go back to him when it's time to really delve into my surgery options - he's my go to resource for this now), and then this most recent lancing at the ER/Labor and Delivery dept, doctor was an actual surgeon.

In my general experience over the decades, there's such a huge variety in experience with nurse practitioners and even doctors when it comes to these. I actually went to one one time who had to research it on the internet in front of me and I was outta there, haha!

I would consider looking into the colorectal or even internist option as probably the most efficient from the start.
 
#16
I've heard a lot of folks talk about the smell.. ranging from awful to horrible to "like death" so I believe it's as bad as y'all say.. hopefully the baking soda gauze helps :)

Do you do the gauze & tegaderm yourself ? I'd assume not but I've got to so.. not looking forward to that :-/

I didn't find any of the stuff with gauze in it so.. I'm considering sticking the gauze down first then attempting to put the whole thing on..

I'm going back to have the little bump looked at tomorrow morning for an opinion & going to ask they put one on at that time but after that I'm on my own.

The bump I've got left isn't draining at all anymore it seems.. which makes me think odd.. if there were a sinus tract.. an opening in my skin back there I'd assume it'd still be draining.. weeping.. whatever it may be.

I remember how happy I was when I felt it burst getting out of the car.. mainly from the sudden wet situation from all the fluid.. no blood just fluid & a bit of that mucus that looked like I blew my nose. But alas it wasn't all of it back down to a flat surface :-( so that's why I'm going back in.

I can understand the discomfort coming from it already being at its worst.. infected, swollen & what not but since mine isn't that anymore.. I doubt it'd feel great but hey maybe it wouldn't hurt as much.

I suppose what I should do is just start calling our hospitals & mention the phrase Pilonidal & see where I end up :-D

Lucky find to have located an experienced doctor for yourself :)

I haven't been to many doctors in my life so.. I don't even have a General Practitioner sort of.. on retainer.. haha
 
#17
I understand not having a general doctor already assigned to yourself - I don't either. I kind of attack my issues with individual doctors and that works for me. They always seem so shocked that I don't have a General practitioner - it's like, sure but I don't need a middle man haha!

Yes, I do the gauze myself, mainly bc I have experience doing it and bc I don't want to ask my husband for the help. I'm sure he would but...ehhh, there are certain things that a person can never unsee so....

At first, you might kind of ruin a few pieces of tegaderm or tape and gauze until you get the hang of it - no big deal. (It's kind of like using cling wrap on a bowl - sometimes it sticks to itself and it takes a bit of practice!) The key is to keep it clean and dry, and stay on - it doesn't have to look good. It doesn't hurt to do it, just awkward.

Were you able to find even just regular (no gauze) Tegaderm on Amazon or similar?

especially now that I'm so big with my pregnancy I was laughing so hard at myself trying to get my arms to reach behind me! Yes I still somehow manage to keep my sense of humor through all of this.

I'm glad yours isn't as painful - yes, that means that the lancing procedure (if you have that done) won't be as horrifying as it normally can be. Sounds like you're in a good position in general.

Good luck tomorrow morning! You are correct to go back in - even when they leak/drain on their own, it's never really totally gone unless someone else can really get back there and squeeze it all out. I learned that the hard way earlier this month - thought mine was good to go and nope, still needed more. Check back in because I will be curious how it goes for you.

Sounds totally weird but I love that feeling of the burst when you feel the wetness on the back and know the thing is draining. Means the pain goes away!!

Incidentally - I was at Target today getting household essentials and went to the first aid aisle to see what else was new. Their Tegaderm w gauze pads, 5 pack, retails for $7.99 which was $2 more than what I paid at the grocery store. I was kind of shocked - that's pricey!! I have enough to get by till I can repurchase at the grocery store. Goes to show you how "good" it is though - one patch will literally last me two days.

When you go tomorrow, ask if they can give you a handful of supplies to get you started - you never know. I scored a huge batch of Tegaderm that way.
 
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#18
Well.. I don't have any confidence in the NP I've seen..

She agreed it looked better but didn't have any more advice since that's all it basically was advice that if it got worse again or if I got some sort of insurance we could proceed with a general surgeon removal route.

I asked if it'd be a dermatologist or any specific doctor & got a no a general surgeon..

I'm certainly no doctor either but I know the route I don't want to go..

It is definitely getting a lot better but isn't gone yet either :-(

On a small plus side it doesn't bother me at all at this point.. if I didn't know it was there I wouldn't know it was there..

Going to upload a few more pictures to my picture thread & I'd like to think the small sort of slit at the top of my.. uhm.. self is just the top of the end of the general crack but I also figure if I have a sinus.. that's probably it :-(

I doubt I can do much 'til I have insurance or some sort of something though.. so I'm hopeful it all goes back down to non-existent & I'll try my damn-dest not to irritate the area again..

I agree on the burst.. I was happy to have felt it even if it was a bit of a mess.. shame it wasn't the entire thing though :-(

When you've noticed yours burst has it pretty much done so completely in the sense that it goes back to basically flat skin ?
 
#19
Well...glad you got it seen, at any rate, even though it was uneventful. I'm glad the bump isn't bothering you currently - enjoy this phase, haha.

I've noticed that once my flare up goes away and it's no longer bothering me, to be honest I return to normal life and just enjoy the time without it. Although I need to be working on making surgery decisions, most of the time I'm just so happy it's over (for the time being) that I put it on the back burner.

When mine bursts, even when it's been fully drained by lancing, I should say that at least for me, the skin is never really fully back to flat. It's always somewhat visible - you can tell there's "something" there, like a bubble available to fill up when it does get infected. Even when a flareup situation is long in the past (I've had several years between flareups in the past) there's still a bump visible. At least that's my experience. It just is regular skin color and not reddish, and it shrinks in size but there's always something there.

I wish I had a magic wand that could just BOOOP! Make it disappear forever.