Closed wound incision opened up and draining serous fluid

Discussion in 'Pilonidal Discussions' started by kath127, Mar 29, 2013.

  1. kath127

    kath127 New Member

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    Hi everyone, I'm new to this and have been struggling to deal with my current surgery so thought I would post my story here as have been reading many others over my struggle!

    I'm a 20 year old university student in the UK and have had my PS for around 6 years. It was never a HUGE problem although I had a very small cyst and two sinuses and I feared they were getting worse as they began to drain a lot more than before. I only found out what it was over the last 2 years and have only really pushed myself recently to get the surgery done (thinking better late than never)
    On the 5th March I had a closed incision surgery at a hospital where I live at university, I had around 7 stitches aswell as 4 tension sutures to keep the area apart. A few days after my surgery I came home to my parents house to rest and took time off uni.My healing went smoothly and the only thing which hurt were the digging in oh the tension sutures which I got out 12 days after surgery ( Which was a relief!) Nurses said I had no infection and the area was very clean and neat. 2 days later I had my stitches out (14 days after op) and as soon as I came home the top of my wound opened (small slit) and serous fluid poured out and continued to when I moved. I went straight back to the nurse and she was confused as she said it looked well before and bandaged me up and sent me on my way.

    The next day It seemed to have opened more and the draining was such a pain :( Everytime I had a checkup the nurses would say it was still not infected and just serous fluid build up draining out. I then had a doctor look at it 5 days ago and he told me this was due to dead space filling with the fluid and it was good that it was draining and he said that within 2 weeks I should know whether it would continue to heal from the inside out and drain through the hole or completely open up. I just felt like there was no end and even now the constant changing of dressings is affecting my lifestyle. I saw the nurse again yesterday and the wound has opened slightly at the bottom, the holes are now big enough to pack so she did so with sorbsan ribbon and it didn't hurt all that much which I was surprised about after hearing many stories.The bottom hole hardly drains anythiing atall compared to the top one and I'm confused to as why this is?
    She also didn't pack that much into the bottom one but about 40cm into the top hole which she thinks may have been pushed into the space between the two holes?

    The nurse thinks it may actually all open up which she thinks will be a good thing as she can see how deep it is and she deals with alot of packing rather than closed incisions. She said the bottom was looking a bit red and I said I'd had a bit of a fever the last couple of days so my doctor prescribed my some anti biotics to take for 10 days just incase.

    As it's bank holiday now for the next 4 days I have made appointments every day at the walk in center to have my wound packed.I am slightly worried though as this morning a small part of my dressing fell out of the top hole and it was gunky from the serous fluid but look like it had torn off from the rest of the packing and I am worried now the dressing may be stuck inside under the closed part :S
    I was told to wash out the wound before packing each time with a shower head and if the packing falls out that is okay, so I'm going to do that in a bit before my app but I'm still really worried.

    After reading everyone's horror stories I am really worried that my wound may never heal and in all honesty I just want my wound to open up now so I can see what I am dealing with. I was told to make an appointment with my consultant 4-6 weeks after my surgery and to go to my doctor/nurses if there are any problems. As my consultant is based at my university and is impossible to get hold of, I have just been visiting my doctor and nurses pretty much everyday which has been great help.

    I know it's only been 3 1/2 weeks and compared to others that's nothing but I just feel like everything has gone downhill and am really struggling with my emotions as I'm a very active person and I just feel trapped and disgusting :( I just hope I see some changes soon and that there isn't a huge struggle ahead of me.
     
  2. Fairy84

    Fairy84 New Member

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    Hi Kath,
    I had the same surgery as you on Feb 28th but had dissolvable stitches. All went well for the first ten days but then my wound opened slightly at the top and bottom. It is not deep enough to pack so am having it dressed every day and have been advised to have daily salt baths. I met with my consultant on Tues and he advised that it may take up to two months for it to heal fully!! I was just wondering if you have much pain/discomfort? It's been four weeks since my op and I find it hard to sit down right on my bum as it is quite painful.....
     
  3. kath127

    kath127 New Member

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    Hi Fairy84 thankyou for replying!
    Although I wouldn't wish this on anyone I'm glad there is someone experiencing a similar thing to me. I haven't spoken to my consultant as of yet but both my doctors and nurses tell me not to have baths and to just shower as normal, I use the shower head over my wound before I have it packed although I've just come back from having it packed at the walk in center and the nurse flushed it out for me and gave it a good clean. My wound hasn't been that painful and yesterday before the nurse packed it for the first time I found that It was becoming easier to sit but now with the packing in it feels fairly sore to sit so I try and avoid it as much as possible which is becoming a nightmare already! My nurse told me to just keep taking painkillers. 2 months seems like forever but knowing my luck it may be even longer and I just hope it closes and stays closed permanently! I was just wandering how deep was your wound and can you tell whether it's beginning to close up inside yet? Also do you have any drainage problems either?
     
  4. Fairy84

    Fairy84 New Member

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    It is such a horrible thing and is seriously affecting my day to day activities at this stage, especially my social life!! After listening to various nurses over the past few weeks, I am sorry now that I didn't have the open surgery, I know the recovery time is longer but I have a feeling that I will need another op in the near future if things don't start to improve. I was initially told I would be off work for 2-3 weeks as I work in an office and sit down all day but this is my fourth week off and I think I will need to take next week as well. Do you think you will need to be at home for much longer? I am not sure how deep my wound was but my surgeon told me that it was a very 'clean' excision and that I only had one tract. I have this awful feeling that he might have missed something as it just doesn't feel right but hopefully not. I have a small opening at the top about the width of a pea at the the top and two tiny pinhole openings nearer the bottom of my excision. When it opened initially I had a lot of drainage including blood but there is not as much now. It is hard to tell as the dressings the nurse is using at the moment includes iodine gauze but it seems to have settled down a lot. I find it very difficult to sit for any length of time and would have thought at this stage I should be more comfortable. However, the surgeon seemed happy enough last week and he is very experienced so just need to go with what he says for now. I hope you see some progress soon and that both of us are healed asap :)
     
  5. kath127

    kath127 New Member

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    It is horrible and as I'm a very up and about person It's beginning to really affect me emotionally as I like to go out in the evening for a drink with friends and sitting on a chair on my sides (as I did last night) was very uncomfortable and embarrassing, but I'm really trying to push through and just keep telling myself that people go through much worse. Luckily I've been with my partner for around 7 years and he's very understanding which lets me feel less embarrassed about the whole situation! I have a lot of trouble sleeping as I'm always subconsciously checking my dressings and sleeping on my sides gives me terrible cramps :(
    When I first came to the nurses they said they had never seen an operation for PS done like mine and that they usually pack, and I too am now wishing I just went for it although when I asked my consultant initially about other surgeries he pushed me away from them and said it would be fine which has annoyed me slightly! My consultant really didn't tell me anything about resting or when I would be back and most of what I've been doing has been suggested by this site and others comments! I rested solidly for a good 2 weeks and only walked around the house to stretch my legs and get things/make food. It's been 3 and a half weeks for me now and I don't think I could handle sitting down properly at the moment, I'm mainly scared about the pressure/stretching opening my wound more (which I do want it to) but am worried it will hurt, aswell as my packing falling out and draining coming through my dressings as It's still draining quite a bit. How long did yours drain for? the draining is he one thing that is getting to me most at the moment! As i'm at uni I took 3 weeks off to have my operation and traveled home (hoping I would be 100% by week 3) and I now have 2 weeks off due to the holidays which I guess is very lucky as it's given me a lot of time to rest but I also think I will be taking 1 more extra week off to stay at home and to continue seeing my nurses and doctors here before I move back and change surgeries. I guess I'm also hoping to see some improvement before I do go back aswell as I'm not looking forward to long lectures and will definitely be buying myself a coccyx cushion for when I do return! I hope that your work will understand that you need the time off as I can't imagine anything worse than sitting with this at the moment!

    When I had my surgery I had a very small cyst and 2 pinholes underneath which I imagine were the tracts but I was never told, I'm really hoping my wound isn't too deep though! I was wandering, re your holes getting any bigger or have they stayed the same since your wound opened up? I'm glad that your surgeon seemed happy and it's always such a relief to hear a professional say it's looking good. I hope everything starts looking up for you soon and you manage to get back to work without any trouble!
     
  6. piloparanoia

    piloparanoia New Member

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    Hi Kath!!

    Your story connected with me most, as I am going through currently word for word everything you had written. Sincerely hoping you have healed well since, and would appreciate it so much if you could update me that from your last post if you suffered any further consequence???

    I had a closed excision 2.5 weeks ago, am doing everything possible to aid the healing process, from a revamped diet, to lieing in the sun for an hour, hardly moving around, and lots more! (I've read probably this entire website and many more surgical sites) yesterday while cleaning my wound gently , the top part of the incision split very slightly, and today I have noticed a small pinhole develop in the raw red tissue along the incision line (stitches were removed 10 days post op). I immediately panicked and thought the worst. After conquering anxiety for 2 years, I suffered the worst attack yesterday and again today. The mental stress from thinking the worst case scenario is clearly taking over my life.

    Any reassurance would be the biggest relief. Really really need a bit of positive reassurance from anyone that can tell me is nothing more than a wound drain hole, NOT A pit or tract the surgeon missed :(

    P.s also should probably mention I'm having what seems like healthy drainage. Slightly yellow, tinged with blood, not smelly, in moderate amounts.
     
  7. kath127

    kath127 New Member

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    Hi Piloparanoia!

    here's the link to my most recent post on my recovery! http://www.pilonidal.org/xfforums/i...-and-questions-about-exercising-limits.10160/

    I have been healed now since the end of september so that makes it almost 3 months! And I must say every day is still a struggle in terms of not being anxious about it returning or having any other issues. I constantly make sure I keep any debris away from it and because of the problems I had I still feel my scar is too fragile for creams or other chemicals, so I avoid having bubble baths etc! Since then I've tried to slowly break into exercise although on some re-occurences my scar seemed to have torn slightly from the tension but healed again the next day (quite common and not something to worry about apparently) although I try and take it easy still as a scar can take over a year to 18 months to fully heal! However, I still hear many horror stories and am always looking out for any re-occurrences.

    Back to your story, I completely sympathize for you. My pilonidal battle was so far one of the hardest times of my life, and although I know that seems silly to say it really was! I felt ugly, unfit and like it would only ever get worse. I also suffered a really bad anxiety attack (my first ever). All you have to remember, is that IT WILL END and you will get better. As soon as I had my stitches out the top revealed a small slit and loads of the same slightly yellow fluid came out (serous fluid I believe) my nurses and doctor left this as didn't believe it was bad and said the only thing to do was to let it decide on its own; whether it was to heal up or completely open up. Below and behold, the draining continued, opened up more eventually only leaving a 1cm part of my wound still sealed from the stitches, and the drainage started to smell. I had an aerobic infection which caused my wound to open up and got worse.

    Now I know this is probably the last thing you want to hear, but if your wound opens up, it's okay! It can still heal :) Personally I feel it's unlikely that it's a re-occurence only almost 3 weeks after your surgery and it may just be your wound needing to open up and heal from the inside out.

    I had a lot of problems with infections and was on contiuous antibiotics, my wound over all took 7 months to heal roughly. I would recommend talking to your doctor/nurses about a chance of infection and getting a swab taken. Also the best dressings I recommend would be sorbsan silver ribbon to pack the wound/lay on top depending on what stage you're at and then covering with a mepilex dressing (I've put details about these on my other post)

    Our bodies are amazing things in how they can actually heal themselves and re-grow tissue, we just have to give them a little time and for some things work a little differently unfortuantely. I hope this has given you some comfort but feel free to message me if you have any other questions!

    Kath
     
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  8. piloparanoia

    piloparanoia New Member

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    Thank you so so much for your reply!! It actually put a smile to my face :)

    I read the link you posted and can't believe how alike we are! I'm a university student and a fitness freak myself, so the entire surgery feels like a huge huge step backwards in all the hard work and progress I made towards achieving so many goals. I'm so so happy for you and *touch wood* you stay fit and healthy for life!
    My surgeon packed up and left for a holiday to New Zealand (ironically my home country) a few days after my surgery, and left me in the care of paediatrician without really answering any of my questions relating to my specific case. This other doctor claimed the yellow liquid tinged with blood was infact liquified fat degeneration, however I have done my fair share of reading to understand its a type of Serosanguinous drainage and also that excessive amounts were best to be reported. Today we finally contacted another surgeon who has asked me to come in tomorrow to "probe" around the hole and just generally check the health of my healing, shall ask them to take a swab then. It really annoys me when doctors act arrogant and do not answer your questions because they feel you are too dumb to understand. Many doctors have made jibes at me about todays generations 'googling skills', however I think we have the right to understand our condition and arm ourselves with the knowledge for the best chance at recovery!

    I do have 2 questions for now, 1. When did you start sleeping on your back after surgery? I feel when I do lots of drainage oozes and this scares me.
    and 2. What types of exercises do you recommend are safe once I feel I am adequately healed to ease back into it?

    Thank you so much for helping me through this!! Appreciate it more then you know!
     
  9. kath127

    kath127 New Member

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    Sorry for my late reply Piloparanoia!

    I completely agree with the whole doctors acting arrogant and not answering questions as I've seen my fair share! In my home town which is much smaller than where I go to university I was fortunate enough to only see one doctor who was very kind and 2 nurses who did everything they could to help me to heal and I am very thankful for them. However, at university I was passed from nurse to nurse and had to keep explaining over and over again, eventually I was an expert of it and the googling master! haha. My surgeon also decided to go on holiday and I phoned the nurses at the ward I was in in panic several times but they were little help. Just be persistent and make sure you walk away from every checkup feeling you asked all the questions you wanted to!

    In terms of sleeping on my back, at the beginning of my surgery and my wound opening up I couldn't sleep on my back at all or even on my front as it would drain ridiculous amounts! I was only able to do so after my bad infection cleared up and the draining decreased to a much smaller amount unfortunately. I hope you get to this point soon as there's nothing more frustrating than not being able to stretch out on your back!

    I didn't start exercising until 7 months after my surgery and even now I do very very small amounts. I would recommend doing something like weights, yoga and maybe very light jogging but don't over do it! Me and my boyfriend are going to begin to start jogging everyday again after the new year as we'd both like to get our fitness back in control (deadlines in my 3rd year you see tend to take over your life!) Because of my scar being very fragile I try to do as much as I feel comfortable but I'm still not exercising as much as I'd like unfortunately :( I think it depends on the individual!

    I hope this helped and good luck today with your probing please let me know how you got on!
     
  10. KTJfromUSA

    KTJfromUSA New Member

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    Hi! I just wanted to write and thank you all for sharing your experiences. I just had my surgery on Feb 26th of this year and I'm struggling with healing in the same way as many of you did. Reading all of your stories has helped me feel less anxious and fearful. I have 12 weeks until my wedding and I was hoping to be healed before that so I can swim in the ocean... I think the doctors you all worked with gave much stricter guidelines than mine communicated. I was never informed that I shouldn't sit for long periods of time. (I know that should be very logical) Usually I didn't sit because it was painful. I asked my doctor if I could make a 4 hour drive after my stitches were removed for a family emergency and my doctor said, "Yes, no problem", well... the next day my would reopened and it's been quite a struggle since then. So - as I sat here searching for answers you all gave me some peace. THANK YOU!

    KTJ
     
  11. mcbooger

    mcbooger New Member

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    Hello! I am in the same boat. I had a close incision 7 days ago. All my stitched popped off rather than got removed. I had quite a gaping hole which has filled in quickly, but oozes a lot of serous fluid and I've ripped my skin raw around with all the dressing changes. It's sore, itchy and weepy. No infection but it drives me crazy!
     
  12. Xsarahx25x

    Xsarahx25x New Member

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    Hi kath I am also going through a very similar thing I had my op 6 weeks ago a few days after my op the fluid build up was that bad it burst my stitches and I just had an open wound which I had packed everyday.
    Still today I'm having it packed and there's still fluid leaking from it but from what doctors ect have told me this is a good thing.
    My wound is healing but rather slowly as it sort of stopped healing for a little while but it's starting to heal again.
    I understand your frustration with dressings I feel like I could start my own nurse centre with all the bits I have lol but I have had alot of down times while going through this but it will get better just unfortunately it can take along time.
    Good luck with your recovery
     
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  13. Melbourne_Mum

    Melbourne_Mum New Member

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    Hi, this is a really old thread so I'm not expecting a reply. My daughters wound is open slightly at the bottom end s d draining yellowy brown fluid / it's been 7 weeks since surgery. Now on penicillin. I'm beginning to despair - it takes so long. She can't sit for any length of time and starts university tomorrow with Rick hard seats with hours long lectures. I think she will have to defer. She is devastated.
     
  14. Jeffrey Jones

    Jeffrey Jones New Member

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    Is it common for your wounds to open up after closed surgery? I'm a little worried that mine could, since I'm having closed-wound surgery sooner or later. For those whose wounds opened up, did you do anything that may have caused this? For example, did you sit when you weren't supposed to, or did you fall on the affected area, or perhaps stretch too far? It seems like the stitches should hold, as long as you practically don't do ANYTHING until the thing is fully healed.
     
  15. Tonster

    Tonster Very Helpful

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    In my case the suture line was 25cm and it held well for 2 weeks and I was very good about keeping weight off it.
    There was a bit of serous ooze in the second week which worried me, but nurse and GP had said it was good.
    It was all so numb I didn't really get a good look at the whole thing, it was always covered.

    When the surgeon pulled the stitches out (it stung a bit) but that was nothing. He actually cut a little bit open to let it heal better... in another follow up visit he cut a little more open.

    It's been good in my experience... they try to close it but not if it looks like it's likely to pickup the infection again or if it will have trouble healing.

    I'm going back in for a bit more cleanup in 10 days... he said he will stitch it if he can.... otherwise it will be open. He knows what he's doing.....
     
  16. Melbourne_Mum

    Melbourne_Mum New Member

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    I don't know if it's normal. My daughter has been very careful - we even have a bed set up in the lounge. It's been 9 weeks now and the bottom 0.5cm just won't stop draining. It's a bit infected but she's still on antibiotics. I think it's just luck. Most people seem to be back to work after 2-3 weeks but this is ridiculous! Stitches came out at 3 weeks as they were starting to embed. She hasn't done anything to open it up - I think there's just a lot of fluid inside the wound the had to get out somewhere. I'm sure she's the 3% exception.
     
  17. Happyme61

    Happyme61 Guest

    Hi, I wonder if anyone can advise please.

    I had a small operation to remove a large cyst from the front of my knee cap (2" horizontal wound), a little over 2 weeks ago. 13 days later my 6 sutures were removed and all appeared to be healing well. I tried to keep knee flexion to a minimum, however on day 14 I stupidly bent down to pick something up and it split wide open again. I returned to A&E and it was restitiched (10 sutures this time). I feel like I need to wear a splint, to prevent movement, especially while I'm at work (in a school classroom with 5 year olds, so lots of small chairs). My GP has advised against this, however I am worried my wound will open up again unless I am mega careful! Not so easy in a class of 25 children distracting you all the time. If I could just wear it for short periods during the school day as a preventative measure do you think it would be worthwhile? Also how long realistically would the wound take to fully heal inside and out? Are we talking weeks or months do you think?

    Any advice would be well received.

    Thank you
     
  18. Ktliz144

    Ktliz144 New Member

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    This whole story and all of the comments have really connected with me. I feel I should have been panicked earlier but am just starting to feel it. I found out I had a pilonidal cyst about 11 years ago but was in high school and couldn't get it taken care of. I had a dr that was very supportive (he has done all of my surgeries) and finally about 4 years ago I had my first surgery to remove the cyst. All went so well and I just needed to heal (the open wound sucked but I got used to it).

    About 2 years after, it was still acting up and open so I continued to see my dr and he thought it came back. I had another surgery which resulted in waking up and being told I would need another bc I would have been completely open so much that he didn't want me to be in extremely severe pain. I was so scared but knew i needed it. A few months later I did surgery # 3 with another open wound with packing. Still sucked but I almost feel numb to an extent. Little spots kept opening and then all of a sudden a small upper spot opened that wasn't a part of any prior surgery -__-

    Last month I had surgery #4 and had a closed incision. So different then the other 3! The stitches were killer but I got them out 2 weeks later and started to feel better. I am about a month in now and am in slightly more pain then usual and have some open spots with drainage/ I didn't ever really panic before bc I trust what my dr has to say and do but now- should I be questioning? I am doing wet dressing on the open area. My room mates keep telling me to see another dr (a plastic surgeon) or do something differnt, but should I just hold out and wait for healing? I'm never going to ever be the same after all of this, but is there a light at the end of the tunnel?!
     
  19. Melbourne_Mum

    Melbourne_Mum New Member

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    Hi Ktliz144,
    Sounds like you've already been through the wringer. My daughter's unfortunately didn't heal - we were seeing a wound specialist (cannot recommend this highly enough - there will be one near you) who shows me how to clean and pack the opened area. I was using saline strips to draw out the gunk. Eventually at the 12 week mark, as the hole was getting larger, the surgeon operated again, cleaned it out and closed the hole with more stitches. This time it is not as painful and there is no drainage at all! He is keeping the stitches in until May 9 which makes 4.5 weeks - hope it's not too painful for her, but this part of the wound is directly over her coccyx which is putting pressure on the skin. She is being very careful, sitting only on donut cushion, lying or standing. Very slow walks outside 2 weeks after surgery. But it looks very promising. Holding all my fingers for a great outcome. I don't know if he'd missed some or whether it was just an unlucky infection the first time but she hardly used any pain relief other than paracetamol whereas last time she was on morphine. The surgeon and the wound specialist were very clear however not to do wet dressings and to keep the area as dry as possible which means a hairdryer after a shower on the wound. Getting air in there is very good.
    I think these cysts are just so tricky and our stories are not the norm. Most heal well with a closed incision.
    Have a look for salt strip paper and we also bought that betadine surgical wash from a medical store to wash with (not the betadine in a small bottle from the chemist - that is too thick and sticky, this wash is what surgeons use prior to surgery). And finally dry area with a hairdryer and keep it dry! (Unless showering of course which helps to get the packing out). No salt baths. No baths!
    Also the wound nurse recommended compression shorts to keep the wound stable. Skins, 2XU Etc but proper compression not just bike/Lycra shorts.
    Hope that helps
    All the best
    Heather X
     
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  20. Melbourne_Mum

    Melbourne_Mum New Member

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    Update: unfortunately the skin over the coccyx split again! Went in for a 3rd surgery and now that part is open 1.5cm long and the same deep. Unfortunately it is extremely painful to pack right now but m hoping it will get easier.
    This really is a miserable disease.
     

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