Never healing wound?!

I don't know what your resources are, but wound packing is supposed to gradually reduce the wound size, as it gradually granulates in, not get larger. On the other hand, half a golf ball is not very big (at least to the eyes of a surgical nurse: me), even though it seems like a cavern to you.

The main thing to know is how does the tissue look in there? is it reddish pink, or is there weird drainage, sloughing tissue, etc. to indicate there is an ongoing infection or other wound healing problem? Another thing I find odd is that you are having wound packing done three times a week. Usually, you do not leave packing in for days at a time. It generally is changed daily or more often. Plus, this is something you could do yourself, unless it is in an area you cannot see or manage. Still, someone in your household could be trained to do this. Seems like a real hassle to go to the doctor so often for this.

That aside, if there is no forward progress after a week or two, the surgeon should be involved, or you should be referred to a wound specialist, often this is a specially trained nurse. Other healing methods can be used, such as a wound-vac, or antibiotics, if needed. What concerns me is that your GP is not contacting your surgeon. You'd think that would be a faster pipeline to his ear...

I had a wound infection that split open my wound, festered, got worse, and required packing too. But, once opened, cleaned, and packed, it was OK.

Jan

I had to have an open surgery and afterwards I had a huge open wound from my belly button down to my croch area. My Dr. decided it was best to do a wet to dry to close the wound. Is this the same you are doing because if so like Jan said this should be changed everyday. When I was still in the hospital the nurses were changing my packing twice a day. When I got out of the hospital I had a home health nurse come over and change it and taught my wife how to do it but it had to be changed every single day. It has been 5 months and its finally to the point where it turned into a scar and I no longer have to cover it. I don't understand why you would have to go to the drs office for a dressing change and also believe it should be done everyday to avoid infection. You should bring it to your Drs attention how worried you are because it is not healing. Good Luck.

I have had over a dozen abdominal surgeries and most have split open between the first week and 12 weeks post op...that said most wounds followed a similar pattern as described above...they infect or fill with fluids or both, swell, seep or pop open and then require packing...there have been occasions when the whole scar did not infect and open but only a small section and as it healed another section, higher or lower down, opened up next to it to make the scar look seemingly bigger or worse when in fact it was a second area that opened up...here they use different methods than back home, they inject sterile saline solution into the open wound, pour betadine solution into it and rinse with more saline then lightly pack with wet gauze (Vaseline) until mostly healed and then with dry gauze towards then end when there is no more oozing.
After the first time round the nurse always taught me to do it myself especially since at the beginning it was 2xs/day and nurses only came 1xs.
Talk to your doctor and ask him to explain the progress or seemingly lack of it.
Sharon

They have asked me to go every week day but I'm only 5 weeks post op so can't drive myself and everyone is at work so I struggle to get there. I've asked if a nurse could come to my house and they have refused as I am still mobile which I find quite unfair! I definatly think I could do it on my own or atleast me and my boyfriend together but the nurse always tells me not to touch the wound and wait to see him I stead:/ il be going again tomorrow so I may have to be more firm And ask if they can atleast let
Me do it myself!

What worries me about it being the size of a golf ball now it that 2/3 weeks ago it was only the size of a penny and very dry and clean. They have told me it is aparently not infected but pink and yellow puss oozes from it loads and 12 ours later the dressing is soggy! And I must add its got a crAcking smell! Hopefully they find out more from the swabs!

Thanks for all the advice
It means alot!

Steph xoxo

Yes, be firm. Time to get your surgeon or a wound care SPECIALIST involved.

Steph,
If it stinks and it is oozing that much with yellow pus then it is infected...pus is usually the sign...but that does not mean that you won't heal just that it may take longer...these things can take up to 6 months although 6-12 weeks is the usual....insist on explinations and if needed antibiotics...after all this time it should not be stinking.
Sharon

I went through something similar after my colectomy. The top of the stitched incision had popped open and was oozing a clear and odorless fluid. Long story short, the opening kept getting larger. At this point, two weeks post op, I ended up losing 30-50 cc of fluid out of the hole.

After contacting my surgeon (Mayo Clinic) due to the extreme fluid loss, I was referred to a local surgeon (I'm 1000+ miles away). A dehiscence of the muscle tissue under the skin and fat layers occurred, and emergency surgery was required. Generally speaking the tissues underneath the skin had opened up despite the stitches.

At which point, open closure of the wound has been taking place. It's 99% sealed right now and the scar tissue is visually thicker than you might expect from being stitched up. I was told that open wound closures have less of a chance of getting infected than stitched wounds do.

The problems I explained here were related to prolonged high doses of Prednisone.

You should also know that clear fluid w/out a smell could indicate infection (again due to Prednisone).

Like everyone else, after leaving the hospital I was completing dressing changes daily on my own at home, with a biweekly followup with the surgeon. Though packing was not recommended. I simply soaked 2 4"x4" pieces of gauze, in a 1% betadine and saline solution, folded them in half, then covered the wound area with them. After which, I used 3" foam tape (manufactured by 3M) to keep the gauze on. The foam tape and elasticon are the only two adhesives that worked for me, but the foam tape breathes better and leaves little adhesive on the skin after removing.

As I understand it, a dehiscence of an abdominal closure is extremely rare. Furthermore, the chance of having a wound producing odorless and clear/white/pinkish fluid be infected is also very rare.

Granted that we all know how "rare" our conditions are, whilst still being the select few, I'd recommend getting ahold of your surgeon asap for a follow up.

It doesn't make sense that the wound area keeps getting larger. Having to see the gp to continually pack the wound also doesn't make sense.

My surgery was the end of June, and two short weeks later I lost the massive amount of fluid, described in my previous post, which led to the second emergency surgery.

Before the second surgery, I had the Chief of our Clinic look at my wound. He didn't suspect anything wrong after being informed of a possible dehiscence. Had him talk to my surgical team at Mayo's, he didn't feel comfterable opening the skin an fat layers to be sure. Then I was finally referred to his recommended surgeon.

Point is, the Chief MD realized that there might have been more going on than he had previously experienced.


I don't mean to ramble, but these are my first two posts on the site and its kind of a way to cope with everything. Feel free to contact me and I can e-mail some pictures of the stitched wound that popped open/leaked all the fluid if you wish to compare with your own.

I had a crater-like hole after the second laparotomy in april, and now another crater-like (a bit smaller, the first was about 5cm diameter) now at the previous ostomy location.

the first healed quickly using equin collagen, polyurethane foam and "silver aquacell" (all those advised by a vulnologist) but unfortunately it formed a granuloma and its surgical removing make another smaller hole which I hope will heal.

the second I'm putting the same treatment and it's going well so far.

I advise you to get the opinion of a vulnologist/ advanced wounds treatmant expert.