Excision - Closed Healing

I had an excision of a PC just about 3 weeks ago. The incision is right down the midline. The stitches came out last week and I have been having fluid drain from the incision.

Overall the incision looks good, but there is a little opening at the bottom of the incision. Does anyone know how long it might take for this whole to close?
Do you mean the hole they left open on purpose? Instead of insert and fixing on a drain they left a hole on purpose or thats what they say but we played detective and found a loose stitch?

For me that hole did not close until March and opened again in June. It has now closed again on Wednesday. It kept healing and becoming smaller but then looked big again.

If the hole is near your anus then its not looking good. I am sorry but I have to tell you that it will not heal as its a difficult area to dress and pack. Also its one of those places that don't heal well or don't heal at all.

I also had a hole right on the top of my scar too so I had 2 wounds. I honestly pray this does not happen to you but I am making you aware of this. I have just found out myself that incisions made at the midline are not good so I was shocked to hear that.

I don't understand why the surgeon made a incision to the midline for my op.
This was not a loose stitch. Everything was good until the stitches came out before the incision started draining. The hole is towards the anus of the incision. I have heard that this is the hardest and most difficult part of the incision to heal.
I believe it is the hardest and most difficult to heal; I had a hole there as well which has today developed into a sinus and my pilo is back. I would get it checked out just to be safe.
Have you thought of having a cleft lift?
I just had the surgery 3 weeks ago, I really don't want to go back in for another one this early.

Today I looked at the gauze I placed on the incision, because it has been leaking, and I had some blood now from the top of the incision.... I am starting to get concerned.
Keep an eye on it as it seems to me that it may give you the problems I had with mine. Before you had your stitches out was it leaking then and if yes from where? the lower part of incision or top?

My incision was leaking from the bottom and about 4-5 weeks don't remember exactly how long post op a hole appeared at the top.

So I had the hole near my anus and a hole at the top. Do you see your surgeon anytime soon? I understand you don't want surgery as you have just had surgery. I agree with you there but its does take months for you to get a appointment depending on your location and here in the UK we are put on 3 months waiting list.

After that you get your pre op assessment and then finally you get your appointment. So it takes a long time but its up to you. I hope you heal from the closed excision you have had.

Anyhoo see your surgeon about the leakage of blood from the top of the incision. I hope you don't confirm what i think it is.
what do you think it is? I have been seeing the dr regularly so far after the initial surgery, this is my third follow up tomorrow. i go pretty much weekly.
Hi Nmbr1sun99,
I had a closed surgery in July and also had a part in the midline which hasn't healed properly. Mine is a bit higher up and only recently closed for a week (but then reopened a bit today! ga!).

The thing which I think accelerated my healing finally was giving the wound a lot of air for at least 15 mins a day after my shower. Also I packed it a lot less. Are you packing your wound? How deep is it?

If your surgeon can't give you many more answers you should see if there is a wound care clinic near you.
Best of luck!
Well, my appointment was cancled yesterday... Thanks swine flu, but I am seeing my surgeon today. I have been bleeding for 3 days straight from the top of my incision and it seems that I have not been draining anywhere else. I was not draining before my stitches were taken out. Multiple calls to my surgeons office and the assistants seem to thing that this is normal and just wash and keep gauze on it.... I am not to sure. Thankfully there is no odor or pain.
I think I have something underneath as I feel a golf ball type thing inside but I only get the feel of it. I had my closed excision 1 yr ago and it has been playing around with me. It sometimes opens up then closes and then opens and it also stops and aggravates the bottom hole too.

So I think maybe you have the same problem. I am glad you are seeing your surgeon today let us know what happened.
Well... it turns out that the incision opened up a little.. I have to go back weekly for silver nitrate treatments. Would rather have that than any worse news.
So... Last week I saw my surgeon, because my incision opened up at the top. He said that it happens, and I didn't know it at the time but he actually opened the top of the entire incision so now it is healing from the inside out. I now go in for weekly silver nitrate treatments. My bleeding is down from what it was when the incision originally opened up. Has anyone ever heard of this being done?
My first surgery was an attempt at closed healing, but my sutures also opened up near the bottom area. I think they maybe stitch you loosly in case you have an accumulation of drainage so that it can escape... I don't know. In any case, It took me months to heal a wound from the inside out that was only a couple of centimeters wide and deep. I ended up finding out I had MRSA and that was why it wasn't healing. It finally healed then it kept opening up again. As far as the silver nitrate treatments, I don't want to scare you, but you should know that they do burn... just so your prepared. my doctor tried that at one point to heal my open wound when really the cyst was back and in retrospect the treatment was causing more harm than good. I hope you have better luck than I did, this can be a very lonely and debilitating disease.. were all here for you! Good luck healing, and if it doesn't work out, I would look into a cleft lift surgeon!
I've heard of silver nitrate treatments to promote healing. I'm not really sure how they work. My GP suggested it, but my wound care nurse told me not to do it. Reviews from people on here suggest they hurt a lot, but I'm not sure if they work well. Very mixed!

Did the surgeon say why he is giving the treatments this early? From the info you have given it sounds like the sutures didn't work completely (common) and maybe you have hypergranulation (which causes excessive bleeding and stalls healing), but you can treat that with cream as I did.

Let us know how you go!
I'm 1 month out from closed excision surgery and i've had 3 silver nitrate treatments and I must say that I am very happy. I have to change my gauze atleast 2 times a day and last night to this morning i barely had any fluid or bleeding. Seems like my silver nitrate treatments are working. I have another appointment in 2 days for another treatment and follow up.

I'm just glad I can start bowling again.
Thank you for the information on your closed procedure. I am scheduled to have a closed excision performed tomorrow. I got the impression the incision would be down the midline for me, as well. I hope it will go well.

I don't want to take prescription painkillers, as I am prone to nausea and motion sickness. Do you think I will be able to get by with simple, over-the-counter pain medications? Also, when were you able to sit after the closed procedure? I would like to get back to work as soon as possible, hopefully in just 1 week.
a closed procedure is the riskiest of all the options and seems very rarely stays closed for the duration of healing. closed is also the one that takes forever to get back to sitting cause every movement u have to worry about ripping the stitches and being left with an open wound, plus a closed has a very high incidence of building fluid behind the stitches and the stitches having to be removed, also leaving u with a gaping hole. if u cannot tell by now, i am not a supporter of the closed procedure. i do support everyones choices, i just think the closed should be banned from being able to screw with so many peoples lives.everyone seems to like the idea of closed for your first surgery. its less scary and less messy. i really hope for both of u that this closed will be your last ordeal with this.i just wish that the docs gave better facts before offering this surgery. the reaccurance rate on closed is like 50/50. those r not good odds.

hey, good luck with surgery and please remember we r always here. i'm sorry if i spoke out of turn here but after 5 surgerys and of course some of them being the closed, its soooo hard for me to watch others go thru the same thing.
I was able to sit after a week, but I required a cushion. My incision did open back up but after it did, i made sure to take extra vitamin A, E, Zinc and C along with my multi vitamin. I just had my 4th silver nitrate treatment and my incision is now almost fully closed. I am very happy with the way everything has gone so far. If you can take 2 weeks off of work, that is best advised. Look into short term disability if it is available.