Open wound hasn't healed in 5 months

Discussion in 'Pilonidal Discussions' started by abc00, Feb 3, 2016.

  1. abc00

    abc00 New Member

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    Hi all, I've had my surgery in the beginning of September 2015 - more precisely, the 5th, and it still isn't even nearly healed.

    It was a fairly large wound, around 1.5 x 4 x 1.5in, and has shrunk to approximately 1 x 2.5 x 1in in the first 3 months, but there hasn't been any progress lately... At a checkup a few weeks ago the doc told me that I needed to shave more often as hairs had been getting into the wound (in spite of showering twice daily), which I had started doing, but I still haven't noticed anything except for itchier skin.

    There isn't any pain or discomfort in day to day life, but sitting for hours isn't fun - and I sit at least 10 hours a day due to school.

    I have received Mepilex silver-coated bandages which I still haven't gotten around to trying on, but I hope they're going to promote faster healing...

    Also - I have never had my wound packed after I'd left the hospital (where I remained for 5 days, and had my wound packed), as I was recommended simply taping one to two layers of gauze over the wound.
     
  2. Gerson Perez

    Gerson Perez New Member

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    sorry for asking, could you show pictures?
     
  3. abc00

    abc00 New Member

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    Sorry but I don't think I'd be comfortable doing that.
     
  4. Tonster

    Tonster Very Helpful

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    Hi abc,

    On one hand... you might not have much to worry about, that's a big wound... it speeds up towards the end... as it gets smaller... it will halve in size quicker. People say 3-9 months... you are probably at the upper end.

    I had almost an identical sized wound (all dimensions) done in November and was told it's the biggest the surgeon registrar had seen. It was left open for two weeks, then stitched up and then re-opened slightly twice... and packed every day by a nurse.

    Packing is with slightly wet gauze... not too wet and not too dry but it should keep the wound moist. it should be touching the wound bed and walls but not the skin, then a bandage over the top of that packing. With a big wound they were putting in 2 meters of gauze strip. I thought packing was critical... keep the wound bed moist so the new tissue and debri can be mobilised by the exudation. If it dries out .. and scabs that's not good, should be red raw flesh, (but not red skin around the area)

    Bottom line I'm almost completely healed. Advantage was the closure and re-opening and close medical attention so they kept it out of the danger zone but tried to close it partially at least with stitches.

    I stumbled on this link on the internet... when I read it... I can tell definitely the few different nursing places I've been follow this almost exactly. Problem is.... you really cannot do it yourself.
    https://www.clwk.ca/buddydrive/file/procedure-wound-packing/

    Other thing about sitting down... 10 hrs wow... I a big sitter for about 20 years... longer than that. But I've converted to sitting and standing... alternating... find a way if possible. Take the pressure off and give the wound the best blood flow and opportunity.

    Sorry no medical experience - I'm just another patient.
     
    Last edited: Feb 4, 2016
  5. Dr Immerman

    Dr Immerman Very Helpful

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    Unfortunately what you're describing is not unusual. It usually means that there still is a residual cleft which needs to be flattened out. The cleft lift procedure will usually take care of this problem. I would suggest you see a surgeon skilled in doing the cleft lift procedure. Sometimes, in spite of diligent wound care this will not completely heal, or it will heal and then reopen.
     
  6. abc00

    abc00 New Member

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    Sorry for the late reply... The wound isn't scabbing, it's usually completely a deep blood red color.
    I've actually had my wound packed ONCE after a checkup by a different doctor, it bled a lot and I had to go back the next day for them to remove it as I couldn't do it myself due to it causing much pain.

    I have also started shaving the area around the wound more diligently, and I think there's been some improvement (it's shallower, I'd say ~0.6in) since I last posted, however it is now leaking more yellowish fluid, I guess because the 'bottom' of the wound is now closer to the gauze.

    One more question - Is it normal for the wound to occasionally bleed after a shower? Once in approx a week or slightly longer the wound will start bleeding during/after a shower, I suppose this is due to the stream removing the outermost layer of the skin?

    @Dr Immerman

    Alas, I live in an area that doesn't have any surgeons specialized in such a procedure... Hopefully the wound doesn't require any more surgeries.
     
  7. Tonster

    Tonster Very Helpful

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    In between daily packing, mine never bled during a shower. ie) A nurse packs it daily, but I remove the packing and stand under the shower before each appointment... never blood in my case. Everything was always on the bandage drawn out by the packing.. never red... but almost every other colour between yellow/greenish/brown. Brown was as close as it got to looking like blood.. very minimal and no surges
    0.6 sounds like a good improvement.... the fluid is good, keep it coming out... (if there's too much, you might want a combine or pad too.. not sure if that would help reduce friction too) ie
    when mine is packed, they specifically put a combine over the gauze layer to reduce friction I was told. sometimes taped down, sometimes loose


    (Others please comment too, I only know from similar current experience
     
  8. abc00

    abc00 New Member

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    I might've figured out why the wound is taking so long to heal.

    Between the surgery and starting to go to class again I had smoked very little. When I returned, I started smoking a third to half a pack a day again... And that is exactly when my wound started healing considerably slower.
     
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  9. Tonster

    Tonster Very Helpful

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    Hehe yep... The surgeon registrar told me it stops healing for four hours post cigarette
     
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  10. tyty501

    tyty501 Very Helpful

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    Sounds like you may have a solution to your problem now.
    But if it doesn't close, look into a cleft lift.
    I had an open wound for 4 months, the thing would not close.
    I got a cleft lift, and now I'm 99% healed and almost back to normal.
    Getting a cleft lift was the best thing I've ever done.
    Best of luck my friend.
     
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  11. abc00

    abc00 New Member

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    Yeah, I've been to a checkup a few days ago and the doc said that he would probably have to go in again since he didn't remove all of it - How long did your cleft lift take to fully heal?

    However, I don't want open wound surgery again since I can go in around June 20 at the earliest and HAVE to be healed by early to mid August...

    I have also finally found a private polyclinic that does both cleft lift (Bascom) and fibrin glue techniques and will contact them for a checkup and quote soon.
     
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  12. tyty501

    tyty501 Very Helpful

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    My cleft lift still hasn't healed at the very bottom. So I've got to probably get a minor procedure done to get that skin closed with a plastic surgeon.

    I'm glad you found that private clinic though! That would be the way to go, best of luck!

    Sorry the surgeon didn't get all the junk out :/
     

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