Managing Hard Lumps After Penetrating Wound Recovery: Expert Insights

A hard lump after the healing of a penetrating wound?

Due to a penetrating injury to the chin from a car accident six months ago (indicated by the red line), there has been damage to the terminal branches of the chin nerve, which has been severed.
Although the wounds have healed, there is a sensation of a hard lump in the area circled in green.
I would like to inquire if there are any methods to eliminate this hard lump or if it can only be managed through regular massage.
Since it has been over six months, I would appreciate a doctor's response.
Thank you! Attached is a rough diagram: http://imgur.com/DZKMquT

Li You-shan, 20~29 year old female. Ask Date: 2017/03/10

Dr. Li Zhonghuai reply Surgery

Hello! If the wound has healed and is not painful, there is no need to disturb it.
Sometimes, the hard lump after an injury may take up to a year to gradually soften.
Take care! Changhua Hospital cares about you!

Reply Date: 2017/03/10

More Info

Managing hard lumps after a penetrating wound can be a complex issue, especially when the injury involves nerve damage and significant tissue trauma. In your case, it seems that you sustained a penetrating wound to the chin area, which has healed but left you with a hard lump at the site of the injury. This is not uncommon after such injuries, and there are several factors to consider regarding the management and potential treatment options.

Understanding the Hard Lump
The hard lump you are experiencing could be due to several reasons:
1. Scar Tissue Formation: After a penetrating wound, the body goes through a healing process that often involves the formation of scar tissue. This tissue can sometimes become denser and harder than the surrounding skin, leading to the sensation of a lump.

2. Fibrosis: This is a condition where the tissue becomes thickened and stiff due to excessive collagen deposition during the healing process. It can occur in response to injury and may lead to a palpable lump.

3. Nerve Regeneration: Given that your injury involved the lower jaw and affected the terminal branches of the nerve, the hard lump could also be related to the nerve healing process. Sometimes, nerve regeneration can lead to the formation of neuromas, which are benign growths that can feel like lumps.

Management Strategies
1. Massage: Gentle massage of the area can help in breaking down the dense scar tissue and improving circulation. This may help soften the lump over time. However, it is essential to be cautious and avoid excessive pressure, especially if the area is sensitive.

2. Physical Therapy: Consulting with a physical therapist who specializes in scar management can provide you with tailored exercises and techniques to help reduce the hardness of the lump. They may use modalities such as ultrasound therapy or soft tissue mobilization.

3. Topical Treatments: Some patients find relief using silicone gel sheets or silicone ointments, which can help flatten and soften scars over time. These products are often recommended for hypertrophic scars and keloids.

4. Injections: In some cases, corticosteroid injections may be used to reduce inflammation and flatten the scar tissue. This should be discussed with a healthcare provider, as it may not be suitable for everyone.

5. Surgical Options: If the lump remains bothersome or does not improve with conservative measures, surgical intervention may be considered. This could involve excising the scar tissue or addressing any underlying issues related to nerve damage.

When to Seek Further Medical Advice
Given that it has been six months since your injury, it is advisable to consult with a healthcare professional, such as a plastic surgeon or a dermatologist specializing in scar management. They can assess the lump's characteristics and determine the best course of action based on your specific situation.

Conclusion
In summary, while hard lumps after a penetrating wound can be concerning, there are various management strategies available. Gentle massage, physical therapy, topical treatments, and possibly injections or surgical options can help address the issue. It is essential to have a thorough evaluation by a medical professional to ensure that the lump is benign and to discuss the most effective treatment options tailored to your needs. Remember, healing takes time, and patience is key in managing post-injury complications.

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