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Yet another
topic that you never thought you would need to really
know about in life! All wounds, whether small or large,
open or closed, go through the same basic stages.
Closed procedure wounds just go much faster (but are
also more prone to infection)....
The body is
truly a miracle, and those people who go through open
healing will have an unforgettable experience watching
the healing process of a gaping hole into a small patch
of scar tissue over the 8 weeks of healing.
A Pilonidal
excision wound is also called a "Cavity Wound",
meaning that a large chunk of tissue has been removed,
leaving a cavity. Small cavity wounds can be closed
with stitches (closed healing, healing by first
intention) but larger cavities are in much greater
danger of infection and are thus usually left open to
heal.
This page is
mainly devoted to those with open healing so they can
understand the process as it's happening...
An "open"
healing happens by letting the wound "fill in" from the
bottom. Also called, "healing from the bottom up" or
"healing from the inside out." To be more specific, the
wound will fill itself in by building new tissue
starting at the bottom of the wound. As the bottom
begins to fill in, the sides of the wound also will get
new tissue. The most important part of open healing is
to keep the sides of the wound from touching until the
bottom of the wound has filled in at least halfway. If
the sides of the wound touch, then they can form bridges
and heal together, trapping fluids and exudate deep in
the wound bed. This is where the art of packing comes in
to play.
What a healing
wound should look like is bright red. In the actively
healing phase of a wound, cells multiply, connective
tissue cells form collagen and eventually small, red,
fleshy masses called granulation tissue begin to form.
These masses keep growing and contracting and eventually
the cavity fills up from the bottom. When your doctor
talks about the wound "filling in" this is what he/she
means.
The following
links detail how the process happens:
The Ethicon Wound Closure Manual
(230 pages!) (pdf)
The
Phases of Cutaneous Wound Healing
(pdf)
Principals of Wound Healing (pdf) - Canadian Assoc.
of Wound Healing
www.residentnet.com/private/tissue2.htm
The final result of wound healing is scar tissue.
Sometimes, the body will get a little gung ho and over
heal. This builds up too much scar tissue and usually
your surgeon will use the much dreaded Silver Nitrate to
burn off the excess scar tissue. This usually happens in
the final stages of healing and it is applied via a long
Q-Tip. Some people barely notice and others will feel a
burning sensation for hours. Silver Nitrate is also
sometimes used to spur healing in a wound that has
slowed or stopped.
This page last updated:
03/25/2007
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