Open surgery wound won't heal

Discussion in 'Pilonidal Discussions' started by Meredith, May 19, 2006.

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  1. Meredith

    Meredith New Member

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    Here's my short story:
    23 yr old female; 6 previous pilonidal cyst flare-ups from age 15 to age 23; had open surgery this January 4th 2006 by a great doc in Kansas City

    OK, so here's my problem:
    It's May 19th. I had my open surgery January 4th and this wound of mine is STILL NOT HEALED! My original wound was about 2.5 inches long by 1 inch wide and 1.5 inch deep. Not that bad. I made great progress for the first six weeks. Healed really fast. Went to doc for follow-up visits, everything looked great. Never had any signs of infection. Never had any pain.
    But since late February, my wound has made VERY little progress in healing. It doesn't hurt. It doesn't look odd in any way. It doesn't bleed or ooze hardly at all. I shower daily, air-dry the area, and go about my normal life. The wound stays pretty darn clean, and I don't cover it with any sort of bandage. Right now, it's about the size of a penny in circumference (but is football-shaped), and is maybe a quarter-inch deep. Clean little wound. Just hasn't made any progress for about three months now. If I continue on healing at the rate I'm currently healing, this thing won't be closed for another year at least.

    I have a couple 'hypotheses' on why this may be:
    1)...First of all, the drastic slowing of healing coincided with me stopping packing the wound. BUT, when I stopped packing the wound was when it was so little, I could hardly fit anything in there anymore anyway (1 inch long by .5 inch wide by quarter inch deep). The size of gauze I was packing it with at that point was barely bigger than a q-tip head. I don't think this was a mistake to stop packing it. Just an observation that healing slowed at this point.
    2)...It says on this site that a key to wound healing is the area getting plenty of oxygen. I'm not sure my wound is getting enough air. Because my butt cheeks are pretty deep, and I really have to 'spread-em' to open the wound up. This means, unless I'm pulling at my butt, the wound is totally squished closed from any air throughout the day. Any tips on how to, say, figure out a way to get the butt cheeks spread apart at nighttime when I'm sleeping may be helpful. The only thing I've been doing up to this point is lying on the couch or my bed bent over a couple times a day to expose the area to air.

    Three other things I should mention:
    1)...I'm on graduate student health insurance right now (since February), and that's why I haven't gone straight to a doc. My option at this point is to go to the student health center, which I may do here soon if I can't figure anything else out. But I'm not sure what they'll be able to do for me. Last time I went there, they told me to wait another week or two, and see what would happen. Great, thanks.
    2)...Yes, I've tried Multidex. I've been putting it on the wound for two months now, every night. I thought it seemed to help a little at first, but isn't helping at all any more. Done with the Multidex.
    3)...I'm not just a slow healer. I don't have diabetes. I cut my hand open a few weeks ago during moving, and it healed just fine, very quickly. Other areas of my body get wounded and heal fine. Just not the butt crack.

    So-- other than keeping the wound clean, exposing it to air, and using Multidex, are there any other options for wounds that won't heal? Any ideas on exactly how much I should be exposing the area to air each day? My only reasonable idea on why this thing won't heal is that my butt crack is too deep and the wound just isn't getting enough air-- the wound goes about all day squished tight together, then occasionally is tugged open and stretched when I bend over.

    Thanks for any suggestions,
    Meredith
  2. ChrisR

    ChrisR New Member

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    Hi Meredith, The size and location of your wound sounds about the same as mine. I had my surgery at the end of January and had it packed for 10 weeks after. My wound hasn't fully healed either, but I know that it can take a long time, I've read cases of healing taking up to a year. If your wound isn't bothering you in any way apart from the fact it's not closing up, I wouldn't worry too much about it, you'll get there.
  3. kelsta26

    kelsta26 New Member

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    Meredith, Meredith, Meredith...
    Sorry to say this, but my wound hasnt healed after 2 years! I also live in the Kansas City area, so email me if you want.
    In two weeks, I'm going to speak to another surgeon about having a cleft lift. I too have tried all the creams and powders and have had no success. I'm thinking that a cleft lift is about all that's left for me.
    Sorry you are going through the same thing as me.
  4. stu

    stu New Member

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    Both of my open wound surgeries have taken 6+ months to heal. Hang in there and as long as it doesn't look infected then you're doing fine. Keep trying to take it easy and avoid sitting/standing too aggressively as well as avoid swimming and other activities that could bring bacteria to the area. Keep physical exercise that causes sweating to a minimum as well.
  5. Meredith

    Meredith New Member

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    Temporary update-- I'll update everyone in a couple weeks to see if this is true, but....
    Member Tracie (RN) has helped me find a solution, and these last few days I've actually been seeing progress again!!!! (Million thanks to Tracie)
    She read my post, and suggested that maybe my wound is getting TOO MUCH air and drying out. I had been applying the Multidex, but not putting a bandage on top of the wound. My dad always said 'a wound has got to get air', so I figured if no debris was getting in my wound, I'd be better off leaving it open. Plus, this site has many posts about the importance of getting oxygen to the wound.
    BUT-- mine was probably just getting too dry. Because now that I've been covering it again with a thick gauze and some tape (as Tracie suggested), the Multidex is staying moist, allowing the wound to finally start healing again.
    I'VE SEEN AN AMAZING AMOUNT OF PROGRESS JUST IN THESE LAST FEW DAYS!
    But I'm not going to jinx myself by getting too excited too soon... so I'll let folks know the whole story once my wound is fully healed (cross my fingers...)

    Meredith
  6. Linda

    Linda New Member

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    Multidex usually works very well and I couldn't understand why you weren't having success. That's great that you are seeing progress now! Thanks for letting us know what the problem was. The wound drying out too much certainly makes sense. Keep us updated.
  7. Tracie

    Tracie New Member

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    Multidex is a great wound gel...my wound has filled in greatly in just the week that I've been using it. I think the reason why it wasn't working on Meredith was because she was washing it out with her shower. I think the manufacturer recommends using it with a covering, so if one uses it against manufactuer recommendations, you can't expect it to work like it's designed.

    Without offending anyone, I disagree with the theory that many have posted on the site about allowing air to get to the wound. Excision wounds are whole different animal compared to cuts and scrapes we tend to get. It is good for those types of wounds to be exposed to air, because it allows the body to develop a scab over the wound, which is the natural way our bodies keep the wound bed moist</u>. When we are dealing with the underlying tissues and structures below the dermis, we take away that natural ability because of their deepness and width. It is SOOOOO important to keep excision wounds moist, because cells can't multiply and move across the wound bed if they are dry. Chris, Kelsta, and Stu, this may be the culprit for your slow healing wounds also. I don't know the nature of your wounds, there could be other reasons why your wounds have not healed, but in Meredith's case, too much air was the problem.
  8. stu

    stu New Member

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    That's interesting. I'll have to keep that in mind if I need another surgery. For all of my previous ones I've tried to keep them dry.
  9. Linda

    Linda New Member

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    The wound care center where I took my son said the exact same thing that Tracie is saying. That wounds heal much better when kept moist (not too wet or too dry), and for the same reason that Tracie has explained.
  10. Tracie

    Tracie New Member

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    Thanks Linda for conferring :D
  11. Linda

    Linda New Member

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    You're welcome! I just found more information that explains the many benefits of moist wound healing. One website says:

    "Moist wound healing gives three major benefits:

    Faster Healing-
    Skin is able to form more quickly in a moisture controlled environment. The new epithelial cells can move around more easily, allowing the damaged tissue to repair quickly.

    Less Scarring-
    The likelihood of scarring is reduced because there is no scab formation.

    Reduced Pain-
    In open cuts and wounds, the nerve endings are exposed and the wound can feel painful. With a moist environment, the nerve endings are cushioned and protected by the moisture which gives relief from pain."


    Also, it also prevents dressings from adhering to the wound and damaging the fragile tissue when the dressing is removed.
  12. Tracie

    Tracie New Member

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    The nerve endings being exposed is a biggy for me. I can tell when my packing has dried out too much because I suddenly start hurting...like lightning bolts through my wound. [:xX] Then I know it's time to change my dressing.

    I hope this thread puts this "air bathing" theory to rest once and for all. It will save alot of people in the future from suffering from nonhealing wounds because of misinformation. Thanks Linda for finding the info to support what I was saying (had relatives over for dinner and didn't have time to find the info myself).
  13. Peqkx

    Peqkx New Member

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    i had open surgery dec. 16 05 and it's still healing.

    i had open surgery dec. 16 05 and it's still healing. the wound is maybe the size of a dime and not sure how deep, maybe .5 inches to 1 inch.

    still packing. still bleeds onto the packing tape and pads.


    it could be my diet.
  14. Peqkx

    Peqkx New Member

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    i keep mine covered and with the summer and all it gets wet from sweat and such but i don't moisten the tape before i pack it.
  15. Peqkx

    Peqkx New Member

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    first we will need full body pics to be sure the cyst hasn't spread. :p


    jk
  16. Meredith

    Meredith New Member

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    Wound finally healed!!!!

    My open surgery wound is finally healed!!! It's been completely closed for about a week or so, and you can't even see where the incision was before. I'm having no pain, and hope this is the end to my pilonidal cyst battle!
    Just wanted to let you all know, though, that I've found a wound healing product that worked even better for me than Multidex. My open surgery was in January of this year, and in May member Tracie helped me out by suggesting that my wound may not be healing because it was too dry, as I was leaving it uncovered and it kept drying out after only a few hours. Tracie had suggested covering the wound and applying Multidex (note that I had been using Multidex for a couple months...) This worked for me for a week or so and I was seeing great progress. But then after another 2-3 weeks, I stopped seeing any progress again in healing.
    So... I happened to be checking the first aid section at our local grocery store, hoping that I may find a different wound healing gel that would help me heal up better, and ran across Zim's Wound Care Advanced Collagen Gel, "doctor recommended for minor cuts and abrasions, traumatic and surgical wounds, burns, etc." This stuff worked GREAT. After using it for about two weeks, my wound is completely closed, with no visible scar. Multidex kinda worked for me, sometimes... but I was much more impressed by the speedy results from Zim's Collagen gel. About $20, and worked like a charm. I'd love to see if anyone else has had good luck with this one, too!
    So, hopefully I done with all this! I put all the wound care gels, bandages, qtips and gauze away in the linen closet, and hope to go swimming some time here in the next couple weeks. Woo hoo!
    Best of luck to all!

    (And on a final note for those of you considering the surgery... Yes, it took me 6 months to heal, and it sucked. But as long as this surgery is my only and last, it was totally worth it.)
  17. Linda

    Linda New Member

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    Meredith,
    That's wonderful that your wound is healed now! I'm glad you let us know what worked for you. It's good to know that Zim's Wound Care Advanced Collagen Gel is another product that can help people who are having a problem getting their wound to finish healing. Good luck to you!
  18. mattb

    mattb New Member

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    Tracie...you should be a doctor! I live in the Denver area, and after visiting a wound care center, they said the key is to keep it moist.

    My healing came to a standstill after week 12. I've tried just about everything. But since the Wound Care visit, I've been packing my wound with a moistened gauze (used Blairex to moisten) and eating lots of protein. I also have my wife shave the area every 3 weeks.

    My wound closed, but every now and then a pinhole will form...which will close up in 2 days. I hope it's because of weak tissue and not another abscess.
  19. VAKelly

    VAKelly New Member

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    Oxygen vs. Packing/Moisture

    Hi everyone,
    Interesting discussion, as it seems these types of wounds heal (or don't) differently in each person.

    My husband had his first open excision in 1999, and it wouldn't close--sounds similar in size/location to yours. We were also told to keep packing, keep it moist, etc. However, by January 2006 it was back in full force and very painful. We tried everything: z-plasty surgery, multidex gel, wound healing centers, etc.

    We contacted Dr. Bascom, who invented the Cleft Lift procedure specifically to "move" the area of healing up toward an oxygenated environment. He has some interesting insights in his articles posted in this site.

    Ultimately we chose to have Dr. Bascom perform his surgery; it's been 4 weeks post-op and my husband is doing great. Best of all, there's no packing since it is a closed surgery! Bear in mind, ours was a very complicated case, but I'm sharing this information so you might not have to endure what we have.

    Hope you can find some relief and healing!!
    VAKelly
  20. assache

    assache New Member

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    It has been about 3 years, but I recall having to dip my gauze (the kind that came in a jar) in a sterile saline salution (i recall i had a prescription for it) before packing it in my wound. I went through two huge bottles in my healing process. I have lost track, but i am pretty certain it was 4-5 months. I kept it covered till the bitter end..i had tape marks on my ass forever! The healing is a bitch-from gloves to gauze I didn't give up. The primary reason why I didn't is I had a friend how had a horrific scar from hers many years prior and I was determined to be good. Not to mention I am hypocondriac.

    It is interesting to note that a lot of the post-op/healing information is contingent on the staff's familarity with these kinds of wounds.

    Multidex was not mentioned on these boards back in the day, but I'm off to google it.

    I am glad you are getting better!
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