9.25 injured, fixed with surgical nails and steel nails on the same day, the instep wound has not improved for 20 days, and began to bleed. During this period, change dressing and disinfect once every two days. Do you consider skin grafting in this situation?
According to your description of symptoms and uploaded pictures, consider the wound formed after foot trauma, which is mainly caused by severe injury and rubbing the skin. In this case, if the tendon and bone are not exposed, it can be treated by dressing change or skin grafting to accelerate local healing.
According to the condition you described, after the injury, the foot shown in the photo is obviously damaged. For this, first, aseptic disinfection should be carried out to make the local injured place produce new granulation tissue and avoid its infection. Secondly, skin flap grafting should be selected in the place where it cannot heal to effectively promote its healing.
In this case, skin grafting should be considered, because the blackened position on the instep has been necrotic, and real skin will not grow under the necrotic. Only hard scars can be formed in the later stage, which may affect the activity or pain of the foot, or some uncomfortable feelings.