Wound Care for Scrotal Injuries: Expert Insights

May I ask the doctor?

Hello Dr.
Du,
I previously consulted you regarding a wound issue with my father.
He had a pimple on his scrotum that turned into a small wound (originally about 0.2 cm) and became infected, resulting in a larger wound of approximately 1 cm.
The wound has now been present for about 10 days.
The area around the wound is no longer red or swollen and seems to be drying out, but there is still a white membrane about the size of a grain of rice at the wound site.
I would like to ask you further questions, Dr.
Du.
My father finally went to see a doctor, but it was a dermatologist (as he had a follow-up for athlete's foot).
The dermatologist prescribed fusidic acid and mentioned that the wound is about 80% healed, advising us to keep it dry without covering it, as the skin will eventually fall off.
They said that artificial skin would not be suitable for the scrotum due to heat.
1.
Is this white membrane dead skin or part of the skin tissue? I am hesitant to touch it, as I have heard that dead skin can hinder wound healing.
Will this layer fall off on its own if we keep it dry? Some people say we should see a urologist for surgical debridement.
I am particularly concerned about the scrotal area, as it may be difficult to remove while washing.
Will the skin's metabolism help it to shed naturally in that area?
2.
Should I insist on taking him to a urologist for this scrotal wound? Will a dermatologist be able to address it? (However, it is difficult to persuade elderly individuals.)
3.
The wound is only 10 days old and not fully healed.
How long does it typically take for wounds in this area to heal? Is it acceptable to leave it uncovered? (I currently have it covered.)
4.
What other signs should I monitor to determine if I need to take him to a urologist? (I am particularly worried that a small wound could develop into necrotizing fasciitis.) I truly appreciate your help with these common knowledge questions.
Thank you.

vivian244, 50~59 year old female. Ask Date: 2017/08/23

Dr. Du Shixi reply Urology

Please cherish our online medical resources.
When asking the same question, please specify only one physician or nutritionist.
Hello: 1) What is the white membrane? I cannot provide feedback as I haven't seen it (the wound should be kept clean and dry).
2) Dermatology can also manage this.
3) It may take about 2 weeks to heal, as long as there is no further inflammation.
4) If there is redness, swelling, or if the wound is enlarging, you should see a doctor.
Wishing you good health.

Reply Date: 2017/08/23

More Info

When dealing with scrotal injuries, especially those that have become infected, it is crucial to approach wound care with caution and an understanding of the healing process. Based on your description, it seems that your father's scrotal wound has shown some signs of improvement, but there are still several important considerations to keep in mind.

1. Understanding the White Membrane: The white membrane you observe on the wound is likely a combination of necrotic tissue (dead tissue) and granulation tissue, which is part of the healing process. While some necrotic tissue may need to be removed for optimal healing, it is essential to avoid aggressive manipulation of the wound, especially in sensitive areas like the scrotum. The skin in this region is delicate, and any unnecessary trauma can lead to further complications or delayed healing. If the membrane does not cause pain or show signs of infection (such as increased redness, swelling, or discharge), it may eventually slough off as the wound continues to heal.

2. Consulting the Right Specialist: While the dermatologist has provided some care, it is understandable to have concerns about whether a urologist or a surgeon specializing in scrotal injuries should be consulted. If the wound does not show significant improvement or if there are any signs of complications, it would be prudent to seek a second opinion from a urologist. They can provide a more specialized assessment of the wound and determine if any further intervention, such as debridement, is necessary.
3. Healing Timeframe: Scrotal wounds can vary in healing time depending on the severity of the injury and the individual's overall health. Generally, minor wounds may take a couple of weeks to heal, while more significant injuries could take longer. Given that your father's wound is approximately 10 days old and has shown signs of drying out and no longer being red or swollen, this is a positive sign. However, it is essential to monitor the wound closely for any changes.

4. Wound Care Practices: Keeping the wound clean and dry is crucial. If the dermatologist has advised against covering the wound, it is likely because the scrotal area can retain moisture, which may promote bacterial growth. However, if you feel more comfortable covering it, ensure that the dressing is breathable and changed regularly to prevent moisture buildup. It is also important to avoid any irritants, such as harsh soaps or lotions, in the area.

5. Signs of Complications: You should be vigilant for any signs that may indicate a worsening condition. These include increased pain, swelling, redness, or discharge from the wound. If any of these symptoms occur, it is essential to seek medical attention promptly. Necrotizing fasciitis is a rare but serious condition that can arise from untreated infections, so being proactive about any changes is vital.

6. Emotional Support and Education: It is understandable to feel anxious about the healing process, especially with concerns about potential complications. Providing emotional support to your father and educating him about the healing process can help alleviate some of the fears associated with the injury. Encourage him to maintain open communication with healthcare providers and to voice any concerns he may have.

In summary, while your father's wound appears to be healing, it is essential to continue monitoring it closely and to consult with a urologist if there are any concerns about the healing process. Keeping the wound clean and dry, understanding the healing stages, and being aware of potential complications are key components of effective wound care.

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