Open excision healing advice please

Matt1010

New Member
Hi, I had open excision surgery on 5th april this year, coming up to the three week mark and still having daily visits from the District Nurses.

The first nurse who came out the day after my surgery measured my wound and said it was 6cm long, 5cm wide, and 3cm deep.
No nurse has actually measured it since until I asked the nurse yesterday out of curiosity to see how it was healing, and she said it was 3cm deep still but didn't measure length or width.

Is it normal for my would to still b 3cm deep 3 weeks into recovery?

I should probably mention too that its still bleeding quite a bit, every morning i remove the dressing and shower to clean the area and put a dressing back over the top until the nurse comes out to repack the wound. They are all saying its showing no signs of infection but im just worrying because surely if everything was fine then it wouldn't be so deep still right?

I've already had nearly 3 weeks off, my surgeon wrote on my doctors note 'at least 4 weeks'. I have an appointment with him to check how its doing on thursday this week (24/04/17) but I'm just worried because it's still as deep as it was at day 1 after surgery.
 

Kelmisty

New Member
I had my surgery on 30th January and I've still got a hole which is healing very very slowly. Still off work.....
 

Goldfish

New Member
Hi, I had open excision surgery on 5th april this year, coming up to the three week mark and still having daily visits from the District Nurses.

The first nurse who came out the day after my surgery measured my wound and said it was 6cm long, 5cm wide, and 3cm deep.
No nurse has actually measured it since until I asked the nurse yesterday out of curiosity to see how it was healing, and she said it was 3cm deep still but didn't measure length or width.

Is it normal for my would to still b 3cm deep 3 weeks into recovery?

I should probably mention too that its still bleeding quite a bit, every morning i remove the dressing and shower to clean the area and put a dressing back over the top until the nurse comes out to repack the wound. They are all saying its showing no signs of infection but im just worrying because surely if everything was fine then it wouldn't be so deep still right?

I've already had nearly 3 weeks off, my surgeon wrote on my doctors note 'at least 4 weeks'. I have an appointment with him to check how its doing on thursday this week (24/04/17) but I'm just worried because it's still as deep as it was at day 1 after surgery.

I had my surgery 7 weeks ago, no depth, 2cm by 2cm and it's still 2cm by 2cm.
 

InGodWeTrust

New Member
How is it at the moment? As in width/length/depth? I advise ( IF YOU SMOKE to stop for the time being ) and you should eat a good diet. Like oranges,apples,chicken soup,and Hamburgers. Because you'll want your body to have a good chance to help itself. You should probably use Aqua cell or collogen dressings. They help the body when things look like it's going slowly. Don't worry it'll heal. Don't walk fast, or sitting. But do move round so your blood can flow. Let your would breathe. Let it get some air, either let the wound be out there or just have your boxers out so the wound won't be getting warm. Patience is the Key to this journey, Trust me.
 

John1

New Member
I had mine removed 5 weeks ago and with a wound that was about 10cm long, 6cm wide and 4cm deep. It has only started to shrink in the last 3 weeks, very slow to start but then suddenly in the past 2 weeks it is almost half the size. As for the bleeding, i'm still having dressings changed every 2 days because they're too full to last any longer. Patience is key and don't worry about infection, the nurses will immediately spot one (i had one and the wound was apparently very red, and there was a very very unpleasant odour). Good luck!
 
Hi John, that wound sounds huge, is it because that was the size of the cyst? I'm a bit confused as to what they did exactly... did they remove the pits in the midline if you had any as well, or... ?
 

John1

New Member
Hi John, that wound sounds huge, is it because that was the size of the cyst? I'm a bit confused as to what they did exactly... did they remove the pits in the midline if you had any as well, or... ?
No, I never had the 'cyst' but a 'sinus' instead. I had a major opening at the top of my 'crack' which then tracked down the crack to another major opening just above my back passage (so I had 2 major draining holes joined by a tunnel with smaller holes in between) They cut out the whole length and basically down to the bone. I did then also have a skin graft due to the severity of the wound.
 
Interesting, thanks. Do you have any pics of before/after?

Im trying to wrap my head around open excision and wondering whether it's what I had in 07. Basically I was put under general it was opened up and there was a big nasty hair/debris ball (ugh). Then it was packed with string gauze... I don't know whether I had pits back then, I assume so because I later did before I got the cleft lift. And I'm wondering if the cyst itself was excised, or just drained...

My cleft lift was 10cm long too... So essentially they cut something similar to what's cut in a cleft lift, but deeper for some reason? Then left it open? The "tunnel" was made of what if you know?

It seems like you've done your research, why didn't you consider a pit picking or cleft lift if I may ask?
 

John1

New Member
Interesting, thanks. Do you have any pics of before/after?

Im trying to wrap my head around open excision and wondering whether it's what I had in 07. Basically I was put under general it was opened up and there was a big nasty hair/debris ball (ugh). Then it was packed with string gauze... I don't know whether I had pits back then, I assume so because I later did before I got the cleft lift. And I'm wondering if the cyst itself was excised, or just drained...

My cleft lift was 10cm long too... So essentially they cut something similar to what's cut in a cleft lift, but deeper for some reason? Then left it open? The "tunnel" was made of what if you know?

It seems like you've done your research, why didn't you consider a pit picking or cleft lift if I may ask?

It doesn't sound like it was excised, that would involve physically cutting out large amounts of flesh (like what you would have had before the cleft lift). They had to cut deeper because I'd developed a very severe form of the disease. I initially saw 2 general surgeons who both referred me on because they'd never dealt with a case so bad but didn't want to leave me with an open wound because it was so big. The 2nd one then referred me to a plastic surgeon and together those 2 performed the operation (general removed it and then plastic did the skin graft). I don't know what the tunnel was made of, it was under the skin and obviously I never saw it, all I know is it was where all the pus/hair was and joined up the 2 main holes. I didn't have a 'pit picking' because mine was far too severe, they said they couldn't even do a primary excision and closure because the wound would be too big to close and they didn't think they'd be able to stitch it together. I didn't have a cleft lift because 1- my plastic surgeon said he'd had more successes with skin grafts and 2- he didn't want to do the flap and then find he'd missed some of the infection meaning it would come back, we agreed I'd have the skin graft and then in a few years if there's no sign of infection I might have a cleft lift for a nicer finish. Unfortunately I don't have any photos - I haven't seen the wound myself thankfully!!! And I wouldn't say I've done my research but rather I've had a lot of doctors research me because they hadn't seen anything like it so I know a lot about it now! :)
 
Very interesting, thanks so much for your feedback. I thought open excision was just the cyst/lump itself, I didn't realize it involved excising the part of the cleft with pits, too. I guess you're right mine was just drained and packed.

There really should be a very comprehensive glossary with pics, yknow? Even now I had to write cyst"/lump" to prevent ambiguity.

If you don't mind a couple more Qs, how long did you have it to get so bad, and what if anything did you do before the excision treatment wise? How did the surgeons know beforehand how extensive it was, an abnormally large lump between the two main draining pits? Size or # of pits?

Sounds like you're doing much better now, that's great.
 
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John1

New Member
Very interesting, thanks so much for your feedback. I thought open excision was just the cyst/lump itself, I didn't realize it involved excising the part of the cleft with pits, too. I guess you're right mine was just drained and packed.

There really should be a very comprehensive glossary with pics, yknow? Even now I had to write cyst"/lump" to prevent ambiguity.

If you don't mind a couple more Qs, how long did you have it to get so bad? How did the surgeons know beforehand how extensive it was, an abnormally large lump between the two main draining pits? Size or # of pits?

Sounds like you're doing much better now, that's great.

I had it for 6 months before it got that bad. They knew it was bad because of the distance between the 2 main holes and the discharge/pain that came with it. There was no lump. But the small holes between the 2 main holes showed there was a 'tunnel' underneath which then lead to the decision to excise the whole thing. Normally you'd have 1 opening at the top of the crack, I had 1 at the top and effectively 1 at the bottom. Too large to stitch back together so they went for a much deeper surgery instead! They also went deeper than completely necessary because obviously it means it's less likely to come back as the chance of any infected tissue being left is minimal!!!
 
Interesting. I had 4 pits basically spread around my entire cleft from what I can remember, leading to the lump near the anus. I do remember feeling them throughout the years after I had the initial lancing. If I knew they were actually HOLES I would have freaked out and done something ASAP. The idea of such a vulnerable/private area actually having holes into your body still makes me shudder.
Here's hoping you never have to deal with it again.
 

Johnathan Irons

Very Helpful
Generally doctors don't perform cleft lift because only highly trained surgeons can perform it properly.
I've heard a lot of stories where doctors suggest alternatives because that's all they know. Cleft lift has the best success rate.

Miss Senapati in Portsmouth is one of the top surgeons in the world for cleft lift. Consider her if you want to get rid of it.
 
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