Managing Post-Surgical Wound Complications: Expert Advice

Wound care follow-up?

Hello, doctor.
I am the one who asked question 128288.
After my father's skin tag was removed from the groin area, the wound has healed, but we found that using artificial skin on the more delicate skin in the groin has resulted in a new wound that resembles a friction burn.
The current wound and surrounding area are slightly red.
I apologize for bothering you, but I would like to ask the following:
1.
Since removing the artificial skin is somewhat painful and the skin in the groin is more delicate, I am hesitant to continue using the artificial skin.
Currently, I am only applying a regular antibiotic ointment without covering it.
Should I cover it? (My father says it is uncomfortable every time it is removed.) If the wound stabilizes in a few days, can we still use the artificial skin?
2.
Sometimes, after applying the antibiotic ointment for a few days, a thin film of dead skin seems to form over the wound.
How should I handle this? Should I specifically remove it, or what type of wound care ointment should I use? Will this thin film of dead skin or scab fall off on its own if I don’t pick at it? (Otherwise, the wound may not heal properly, right?)
3.
If the wound and surrounding area are slightly red but there is no swelling, heat, or pain, is this still considered inflammation or could it be an allergic reaction? Is applying antibiotic ointment effective?
4.
How many times a day should the wound be dressed? How long should the entire process take before I should see a doctor?
I really didn’t expect that using artificial skin would cause a new wound...
I truly regret not leaving it alone.
Thank you.

vivian244, 40~49 year old female. Ask Date: 2017/09/24

Dr. Chen Jiaming reply Surgery

The use of artificial skin not only serves to isolate contaminants but can also reduce the frequency of dressing changes for wounds with minimal exudate.
Your mention of pain when removing the artificial skin indicates that you may be removing it before it is necessary, which can lead to repeated adhesion damage to the epidermal layer.
Adjusting the frequency of use can help mitigate this issue.
The thin film that forms over the wound may sometimes be a biofilm produced by microorganisms, which can indeed affect the final healing of the wound.
However, post-removal wound care still requires professional handling and advice, and it is recommended to seek evaluation at a general surgery or wound clinic.
The frequency of dressing changes varies for each wound and cannot be generalized.

Reply Date: 2017/09/24

More Info

Managing post-surgical wound complications can be a complex process, especially when dealing with sensitive areas like the groin. Here are some expert recommendations based on your concerns:
1. Use of Artificial Skin: If the artificial skin (or "人工皮") is causing discomfort and pain during removal, it may be best to discontinue its use. The groin area is particularly delicate, and if the artificial skin is causing irritation or new wounds, it’s advisable to allow the skin to breathe. You can apply a topical antibiotic ointment, such as bacitracin or Neosporin, to help prevent infection and promote healing. Covering the wound with a sterile gauze may be beneficial to protect it from friction and further irritation, but ensure that it is not too tight or restrictive.

2. Handling Dead Skin or Scabs: The thin layer of dead skin or scab that forms over a healing wound is a natural part of the healing process. It is generally not advisable to forcibly remove this layer, as it serves as a protective barrier for the underlying tissue. Instead, keep the area clean and moisturized. If the scab becomes too thick or is causing discomfort, you can gently clean the area with saline solution and apply a thin layer of antibiotic ointment. Over time, the scab will naturally fall off as the underlying skin heals.

3. Redness and Inflammation: Mild redness around the wound is common during the healing process, but if there is no swelling, heat, or significant pain, it may not indicate an infection. However, if the redness persists or worsens, it could be a sign of inflammation or an allergic reaction. Applying a topical antibiotic can help, but if you notice any signs of infection (increased redness, swelling, warmth, or pus), it’s crucial to consult a healthcare professional.

4. Frequency of Dressing Changes: The frequency of dressing changes can depend on the wound's condition. Generally, it is advisable to change the dressing at least once a day or whenever it becomes wet or dirty. Keeping the wound clean and dry is essential for optimal healing. If the wound is healing well, you may not need to change the dressing as frequently. Monitor the wound for any changes, and if you notice any concerning signs, seek medical advice.

5. When to Seek Medical Attention: If the wound does not show signs of improvement within a week or if you experience increased pain, swelling, or discharge, it is important to consult a healthcare provider. They can assess the wound and determine if further treatment is necessary.

In summary, managing post-surgical wounds requires careful attention to hygiene, monitoring for signs of infection, and making adjustments based on the wound's response to treatment. If discomfort persists or complications arise, do not hesitate to reach out to a healthcare professional for guidance. Healing can take time, and it’s essential to be patient and attentive to your body’s signals.

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