 Poster: A snowHead
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Last summer I had some surgery to my lower leg because of problems with a skin graft done about thirty years ago (motorcycle accident of course). The surgery has cured the original problem on the front of my shin but I now have a new skin graft on the inside of my lower leg, just above my ankle bone.
I tried skiing at MK this weekend and found, after I took my boots off, that a lot of skin had been rubbed off or was blistered quite badly. This was after only 2 hours of skiing. Anyone got any ideas how I could stop this happening as otherwise it will be the end of my skiing after 25 years?
I have wondered if cut off tights (pop socks?) might work?
Should I try to toughen the skin with surgical spirit rather than keeping it moist with E45 cream?
I currently use some very thin ski socks (Fox), and keep the upper clips of my boots fairly tight.
Any suggestions gratefully received!
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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John Scott, I would suggest a specialist blister plaster. They help the skin breathe but act as a second skin absorbing all the friction. Dont forget to shave first though, helps both adhesion and removal.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Frosty the Snowman, thanks for the suggestion but the area is quite a lot bigger than blister plasters, probably about 50mm x 70mm.
No need to shave as skin grafted skin doesn't have hair!
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You need to Login to know who's really who.
You need to Login to know who's really who.
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John Scott, I am sure you can get it in rolls. Perhaps speak to your doc or even a pharmacist (why not PM Helen Beaumont).
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Sounds nasty. Personally I have my boot tops relatively loose.
Long ago my dad did a skin graft from a guy's chest onto the cut-off tip of his thumb. Consequence - he had black hairs coming out of the end of his thumb! My father offered to redo it but the guy was very proud of his hairy thumb.
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You'll need to Register first of course.
You'll need to Register first of course.
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I had loads of blisters 3 summers ago when i chopped down what seemed like an innocent but large weed.
turned out to be 'GIANT HOGWEED'
I, of course, had shorts and t-shirt on and spent the rest of the day in the garden. Nnext day my forearms and lower legs were covered in blisters (apparently the plant, when mutilated, sprays some sort of light reactive chemical over it's victim).
I went to my GP with my unsightly blisters (and as i was new to the area and hadn't actually registered at the GP they said 'fill out this form and we will make an appointment for you to see the GP in 4 days', nice!. I showed the receptionist my wounds and asked if a GP could just give me some advice on how to treat it - she said '4 DAYS! and slammed down the 'position closed' shutter - not really but just thought i would state that for effect purposes).
So, I went to the nearby chemist, at which point a crowd had gathered and they were jeering me and poking me and....what ...... no, the chemist politely said. hmmm!
So, I went to the A&E at the local hospital who - and this is the reason for the explaination - covered me in VASELINE and bandages and told me to give it a few days and all would be ok. It took about 5 days before i could remove the bandages but it worked.
I suggest, although not from any sort of medical authority, that you put lashings of vaseline over the area and cover with bandages. This should lubricate the area enough to avoid any friction burns.
Beware though, it can be messy!
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Spenco 2nd skin comes in fairly large sheets and is very effetive for hot spots and blisters.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Is it the graft or donor site that blistered?
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doctor_eeyore, it is the graft site where the skin has been rubbed off and been blistered. (half is raw the other half is blistered). The graft was done in May 06 but was quite slow to heal, took till about August I think. I had a flap of skin that was still attached pivoted around to cover my shin and then the place where it came from (my inner lower leg) was skin grafted with skin from my thigh.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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John Scott, there is a gel sheet called epitact from Sidas [the ski footbed people] designed to protect areas just like this, i think it comes in sheets around 5cmx10cm available from many ski shops at a cost of between £11 & £22 depending on pack size.
have you got a footbed in your boots [this is not a cheap plug before someone gets the hump] stabilising the foot will reduce the pronation of your foot which in turn will reduce friction on the area......i would still use a gell sheet of some description as well as that scar is still pretty young
hope this helps
Edit,
i should mention that thease pads are a medical grade gel sheet and do not stick on so to speak, they gentle adhere to the skin, can be taken off, washed and used again the next day
Last edited by snowHeads are a friendly bunch. on Mon 8-01-07 18:12; edited 2 times in total
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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My girlfreind got bad blisters on her shins from a reaction with something or other. We went to the pharmacy in Belle Plagne and they gave us some gel pads. About 4" square. They gently stick to the shin and problem was solved. They were good on the bad area and prevented any more issues.
JP
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as stankane, mentioned vaseline is the miracle cure.. wont do your socks any favours but less hassle than plasters n stuff..
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You know it makes sense.
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John Scott, it might be worth letting your local practice nurse or wound care specialist have a look, but what you might have used before, a vapour permeable film dressing called Tegaderm is available in 15cm x 20cm size, basic NHS cost £2.36, Chemist cost 100% mark-up usually, making it cost effective to get a prescription for them.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Poster: A snowHead
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John Scott, I would be really concerned about this and would advise that you take it very seriously as Linds is hinting. If possible I would start by trying to access the (?plastic) surgeon who did the rotation flap.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Linds, The flap is fine, it healed very quickly and very well. It is where the flap came from that was skin grafted that has become raw.
CEM, yes I,ve got footbeds, I'm so used to them that I couldn't ski without them. I was surprised that the skin was rubbed off as my feet are very well supported - I have Comfortable foam inners that were done about 15 years ago and although they have compressed over the years I keep them tight by adding more felt on the outside. I know it sounds awfull but they do fit very well, and I must have used them for about 100 weeks!
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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John Scott, I have an old opeartion scar which behaves a bit like you have described. When I was in Les Deux Alpes last year, A ski-boot technician recommended some stuff which is a bit like a very large gell dressing. It was amazingly effective. I still have some. Can't access it now - but will be able to later this evening, I think. I'll post details in this thread.
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You need to Login to know who's really who.
You need to Login to know who's really who.
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John Scott, remember that your leg shape will have changed slightly [or greatly] following your surgery, the foam liner might actually be the problem.... difficult to say without seeing it but it may be that the tongue of the liner is not matching your leg shape properly, there are a couple of things in boot terms that may help along with the gel pad.
Firstly applying some padding around the area to take the pressure off the graft directly, or secondly [AND THIS SHOULD BE DONE BY AN EXPERIENCED BOOT FITTER] acetone can be injected into the foam of the tongue to break it down a little and make it a bit softer. alternatively you could try and get a standard replacement tongue for the liners as the ones on there will be velcro attached.
As ever if you need any more lep then just ask 
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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You'll need to Register first of course.
You'll need to Register first of course.
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The reason your skin graft is blistering is because there is no fat padding under the graft. Therefore the sheering interface is maximal at the graft/bed interface. This will improve as the graft matures- it takes about 18 months to 2 years to do so. In the meantime you need to provide an interface that will absorb the sheering force generated when you ski. the best way to do this is to pad out the defect created when the transposition flap was raised to cover the bone. This can be done with "normal" fluffy cheap cotton wool held in place with a relatively tight sock. The nhs in some areas provide pressure garnments specifically measured to fit to your unique leg shape. Your plastic surgeon should be able to arrange this.
You can apply adhesive silicone gell to the skin graft and that will speed its maturation but it will not effectively buffer the sheering forces described above. So the ideal dressing would be- skin graft covered with silicone sheet covered with padding held in place with a synthetic sock(pressure garnment). The aim should be to restore the contour of your leg - the flap will be bulky and stick out - since its insensate it will need some protection.A ski sock can then be worn over all this. Dont despair your skiing days aren't over.
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John Scott, I agree with mij.
The lower leg is a pig of a place to heal, and believe me you do not want to jeopardise the viability of the graft. Thinking from a different angle. Snowboarding boots are a bit softer and more comfy these days than ski boots. How about trying to learn to board and see if you got on with that for a year or 2 (and I speak as a committed skier... or skier who should be committed anyway)
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John Scott, the stuff I was writing about earlier was Epitact Epithelium 27 plasters. It comes in pieces 10cm x 10cm (maybe the same stuff that justapurrin was referring to). Quite expensive, but highly effective.
That said, I have huge respect for the medics on this forum. I have met Linds (no scaredy cat) and skied with stoatsbrother - not the sort to suggest backing off with no good reason. So I would urge you to consider their advice (and that of mij) carefully.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Linds, the flap donor site has not yet filled out, it is still indented but it isn't the edge that has rubbed off but the main part.
mij, What you say makes a lot of sense - once it has healed I will try the combination of gel sheet and cotton wool held in place with a pop sock.
stoatsbrother, I do also snowboard already but was worried because there is so much more movement within my snowboard boots and there is quite a lot of pressure on the inside of my leg, particularly as it is my back foot.
Thanks everybody for the advice, I'm seeing my GP this afternoon so I will mention the various forms of gel sheet to him.
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Martin Nicholas, I am seeing the practice nurse this Friday so I will hopefully get a prescription for some Tagaderm. (Boots could only supply it in 6cm x 7cm size - way too small).
CEM, I was able to get Epitact from Sidas from the Chertsey S&R (helpful bootfitter called Roman Skoda), it came as a pack of two pieces (each 10cm x 10cm) for £20. It does look like good stuff.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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John Scott,
there are also hydrogel sheets available - these are the same jelly stuff that is squirted onto wounds set into a sheet form... can be easily spotted as it LOOKS like clear jelly and when poked at a 45 degree angle you can see little ripples.... one brand was called Clearsite and then it changed its name to Aquaclear - but they were aussie names... they were made in the EU though....(german i think)
these would take up the sheer pressure that may be causing the blister process until you get some more natural padding...
the jelly is set onto a sheet like the tegaderm - so also has some antifriction properties in that backing sheet.... i usually try to use tegaderm/opsite to fix down in a person whose ski is healthy enough to take that.... (remember tegaderm is STRETCHED to remove not peeled)... Opsite can be purchased in rolls... another option is mefix/fixomull etc tape but that will not leave you a 100% water resist dressing area(oil off)
the spenco second skin is like a hydrogel - but cannot be applied to broken skin (read the fine print) - i am guessing that that is because it has a high content of propylene glycol....
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FAQ
) that if your flap was slow to heal and the skin is still that fragile after this length of time you should seek medical advice to both, get the skin healed and the rest of the area covered. Then you can start looking at what is the best thing to protect this area out in your ski boot.
