Wound very low (near anus) - will it heal?

#1
Hey guys -

I had a closed surgery in Baltimore on August 20th. Its now three months post-surgery, and the wound is still not healed. There are actually two (skin formed in the middle creating two) wounds - one higher up which is healing well and is quite small, but then a larger "gash" type wound lower in the cleft - it runs very close to the anus. This wound is only a few milimeters deep, but hasn't progressed in over two weeks. It seems to have stopped healing.

I've been seeing a wound care center twice per week for 2 months. They're knowledgeable, but are not sure the lower wound will heal. I wanted to ask here whether anyone has experience with a wound being so low in the cleft and whether it healed successfully. I figure the sooner I know, the better...one way or the other :(
 
#2
I would highly recommend a cleft lift with Dr. Bascom in Oregon. He is the best around at healing these things and you will be 100% cured in about 2 weeks. Hope this helps. Good luck!
 
#3
I would highly recommend a cleft lift with Dr. Bascom in Oregon. He is the best around at healing these things and you will be 100% cured in about 2 weeks. Hope this helps. Good luck!
thank you for the reply! I actually made the decision just after posting to forget about hoping and praying to heal and to just go get the cleft-lift surgery. I live in Washington DC, so I'm currently signed up for a consultation with another doctor on the list recommended by this site - a Dr. Obias...although I'm curious to know how those surgeons are selected and how they get on the list.
 

LILLY

Very Helpful
#4
Hi RB999. As far as the surgeons on the list they are not exactly selected- they are the only ones that are known to perform cleft lift. They need to seek out the training and that is why there are so few as compared to the number of surgeons performing excision surgery. Since your wound is very low the number of surgeons who can perform the surgery for you may be slightly fewer. If the first surgeon you see isn't able to do it you may have to travel some but it will be worth it so don't give up.
 
#5
i have a super low wound -- i do horse back riding (well did....haven't yet since the pilo) which made the problem even worse. granted this wound was pretty ugly ~5cm deep & around 3cm long after an open excision plus i had a higher one, which is pretty much closed now. Had the surgery back in March (while still in college ,sitting though classes so that didn't help) I've been slow to heal the entire time but had some crappy wound care in the beginning too. switched wound care clinics in august and made a ton of progress since. Now the wound is very superficial and is less than 1cm in length. It's really close to being completely closed up/scarred.

you have to remember that this is an area that doesn't get much oxygen and is a breeding ground for ecoli being so close ...

Several things have contributed to my progress that i started using in august (which are a combination of my own research, wound care's knowlege, and my mom who's a nurse:
#1 silver nitrate-- when wound healing slows down or you get over granulation of tissue it seems to "restart" the healing process... hurts like a b**** but it's worth it
#2 prisma -- contains collagen and something else which eats up all of the bad enzymes in the exudate that slow down healing
#3 tea tree oil --- this was my own discovery. its got antiseptic properties among others beneficial to wound healing (most famously it decreases excess granulation tissue). but you have to use a low dilution (like 2% in saline/water otherwise it irritates and is counterproductive) i've used a conglomeration of treatments but when i started using it, it definitely did no harm
#4 xenoderm or another brand of the same thing (castor oil, lysine and other things) nurses use it alot on pressure ulcers and its been a major player in my healing
#5 loose clothing!

I'm praying slow and steady wins the race in my case. but if this thing breaks open after it's "healed" i'm definitely looking into a cleft lift.
 

RB999

New Member
#6
The wound care center has told me that it is not going to heal on its own (it re-opened to post-surgical size again) so I suppose I need a cleft-lift for sure. Hopefully this DC doctor is good enough, because I'm unable to travel for the procedure. The time necessary to go get the procedure, recover (7-15 days?), and fly back isn't possible for a law student.
 

LILLY

Very Helpful
#7
You won't need to fly. We are in Md and drove to Pittsburgh for surgery with Dr. Rosengart. He has done hundreds including those very low in the cleft. You can come home the next day. If your drain isn't taken out the next morning you would have to drive back a few days later but still better than an extended stay.
 
#8
I'm not familiar with how law school semesters run, but do you get a winter break of any sort that you could get the surgery done then? I had my excision surgery over spring break and was back in class hopped on vicodin 5 days later. Of course, I'm a terrible example of success--BUT my point is, from what i gather, cleft lift surgery has a much faster recovery time and you're back to normal a whole heck of a lot faster than excision surgeries (you can actually sit normally within a week with no problems, right Lilly?)
 

RB999

New Member
#9
You won't need to fly. We are in Md and drove to Pittsburgh for surgery with Dr. Rosengart. He has done hundreds including those very low in the cleft. You can come home the next day. If your drain isn't taken out the next morning you would have to drive back a few days later but still better than an extended stay.
thank you for the replies guys - Lilly, did your son consult with Dr. Rosengart prior to the surgery? Where people need to travel for consultations/surgeries, I've heard that just speaking on the phone and sending pictures has been sufficient, but I was wondering how you guys handled that.
 

LILLY

Very Helpful
#10
We had thought about trying to handle the consultation without making the trip but didn't pursue it. I believe Dr. Rosengart would work with you but I don't know that from experience. We made the trip in June for the consultation and had the surgery in July.

As Kay C said a semester break would be ideal, but other than that I imagine you could work something out. Some people are able to start sitting after a week but not too easily. The extent of your current scarring would lead me to believe 2 to 3 weeks before you could sit for several hours in a row.
 
#11
Unfortunately the law school break is slightly more than two weeks long. So getting to consultation, coming back, then into surgery again in time to keep it all over a break seems highly unlikely. After that comes the Bar Exam and then beginning a career, so I won't have another 2-3 weeks off until...probably my honeymoon (if that were to ever happen).

So it seems as though my options are limited to getting the surgery done here in DC with Dr. Obias (on the Cleft Lift list, but can't find any recommendations/reviews as to that procedure) OR, sending pictures/talking to a doctor further away as a consultation and getting the surgery, hopefully, over the upcoming break.
 

LILLY

Very Helpful
#12
I know how you feel. It's not easy to find the time to recover no matter where you have the surgery done. I hope you are able to get it timed over your break. Please keep us updated.
 
#13
I don't know if this thread is still active, but I have a very similar problem and have started using Medihoney. The problem is that the wound opening is a very small circle, maybe quarter inch in diameter, and when I put Medihoney on it, by the end of the day, it seems to have run out of the wound. I can put gauze near it, but it's difficult to make it stay in place, and even if it is, if the Medihoney is just oozing back out, is it really working?
 
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