Chronic Wound Healing Issues After Surgery

Wound healing issues

Hello Doctor: I had a sebaceous cyst surgery under my left armpit in early November last year.
After the surgery, the wound got infected, and I underwent debridement surgery in January this year.
Up to now, the wound still hasn't healed.
I change the dressing 1-2 times a day; the wound shows signs of healing, but after a few days, it breaks open again, leaking yellow-green fluid.
This cycle has repeated many times—healing and then breaking open again! I would like to know what kind of problem this is and how I can improve it, as it has been a long-standing concern.
Thank you!

Miss Chen, 20~29 year old female. Ask Date: 2020/03/01

Dr. Xu Kaixi reply Surgery

This situation may indicate that infected tissue remains at the original surgical site.
If there are recurrent infections that have not fully healed, it is advisable to consider re-debridement and excision surgery.

Reply Date: 2020/03/01

More Info

Chronic wound healing issues can be quite frustrating and concerning, especially after surgical procedures. Based on your description, it seems that you are experiencing a recurrent problem with your wound healing after a sebaceous cyst removal surgery. The fact that your wound has been infected and has required debridement suggests that there may be underlying factors contributing to the delayed healing process.

Firstly, it is important to understand that wound healing is a complex biological process that involves several stages: hemostasis, inflammation, proliferation, and remodeling. In your case, the presence of yellow-green discharge indicates a possible infection, which can significantly impede the healing process. Infections can lead to increased inflammation, which may cause the wound to break down rather than heal.

Several factors can contribute to chronic wounds, including:
1. Infection: As mentioned, an infection can prevent proper healing. It is crucial to ensure that the wound is kept clean and that any signs of infection are addressed promptly. This may require antibiotics if a bacterial infection is present.

2. Moisture Balance: Wounds need to maintain a proper moisture balance. Too much moisture can lead to maceration of the surrounding skin, while too little can cause the wound to dry out and form scabs, which can impede healing. Using appropriate dressings that maintain a moist environment can be beneficial.

3. Underlying Health Conditions: Conditions such as diabetes, vascular disease, or autoimmune disorders can affect wound healing. If you have any underlying health issues, it is essential to manage them effectively.

4. Nutritional Status: Adequate nutrition is vital for wound healing. Ensure you are consuming a balanced diet rich in proteins, vitamins (especially Vitamin C and Vitamin A), and minerals (like zinc) that support the healing process.

5. Wound Care Techniques: Regular dressing changes are important, but the technique used can also affect healing. It may be beneficial to consult with a wound care specialist who can provide tailored advice and possibly advanced treatments such as negative pressure wound therapy or specialized dressings.

6. Tissue Viability: If there is necrotic (dead) tissue present in the wound, it can prevent healing. Debridement, which you have already undergone, is necessary to remove this tissue. However, if the wound continues to break down, further evaluation may be needed to ensure that all necrotic tissue has been removed.

Given your situation, it is advisable to follow up with your healthcare provider or a wound care specialist. They can assess the wound more thoroughly, possibly perform cultures to identify any pathogens, and adjust your treatment plan accordingly. They may also consider imaging studies if there is concern about deeper tissue involvement or abscess formation.

In summary, chronic wound healing issues can arise from a combination of factors, including infection, moisture imbalance, underlying health conditions, and nutritional status. It is crucial to address these factors comprehensively to promote healing. Regular follow-up with your healthcare provider is essential to monitor the wound's progress and make necessary adjustments to your treatment plan.

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