Post-Surgery Concerns: Healing Issues After Cyst Removal on Face

There is a small puncture hole about 0.5 cm in size on the face 10 days after the stitches were removed?

Hello doctor, ten days ago I had surgery for a sebaceous cyst on my face, with a wound approximately 0.5 cm long.
When the stitches were removed, the nurse said I could start using scar gel, so I began using it at home.
However, it seems to be a bit red and swollen (I have a tendency to develop keloids, so I can't tell if it's keloid formation or if the redness and swelling are due to the scar gel).
After using the gel for two days, I applied a silicone dressing for two days and then continued with the scar gel.

Two days ago, I noticed that the wound (seven days post-stitch removal) has a noticeable hole about the size of a larger needle puncture that hasn't healed.
It looks quite deep, but the surrounding skin is stitched, so it wasn't detected during the stitch removal.
After discovering it, I stopped using the scar gel.
Sometimes there is a bit of serous fluid, but it quickly resolves.
Currently, this hole has been visible for over ten days, while the other areas have healed and are starting to show white scarring.

Will this hole heal on its own because of the serous fluid? If not, will it require reopening and stitching again to heal? What care should I provide to promote healing? Is this situation related to using scar gel while there is still swelling?

Chen Lulu, 30~39 year old female. Ask Date: 2020/05/19

Dr. Li Zhonghuai reply Surgery

Hello! After removing the stitches, it is common to apply a silicone gel sheet.
If the stitch holes have not healed, please return for a follow-up appointment as soon as possible; do not use artificial skin.
Hypertrophic scars will not occur immediately after surgery.
Common issues after stitch removal include poor wound healing and wound dehiscence.
At this time, scar removal gels should not be used.
It is advisable to return for wound management, and you can use scar removal gels once the wound has completely healed.
Take care! Changhua Hospital cares about you!

Reply Date: 2020/05/19

More Info

After undergoing cyst removal surgery on your face, it’s understandable to have concerns about the healing process, especially given your history of keloid formation. The situation you describe, with a noticeable hole at the surgical site that has not healed properly, can be concerning. Here’s a comprehensive overview of what you might expect and how to manage your healing process.

Firstly, it’s important to recognize that the healing process can vary significantly from person to person. Factors such as the size of the incision, the location on the body, individual healing capacity, and pre-existing conditions like keloid formation can all influence how well and how quickly a wound heals. In your case, the presence of a "hole" at the site of the incision suggests that there may be some underlying issues that need to be addressed.

The fact that you have experienced some redness and swelling could indicate inflammation, which is a normal part of the healing process. However, if the redness persists or worsens, or if you notice increased pain or discharge, it could be a sign of infection or other complications. It’s crucial to monitor these symptoms closely.

Regarding the use of scar gel, while these products can be beneficial in promoting healing and minimizing scar formation, they should be used cautiously, especially if you have a tendency to develop keloids. Keloids are raised scars that occur when the body produces too much collagen during the healing process. If you notice that the area becomes more inflamed or red after applying the scar gel, it may be best to discontinue use and consult with your healthcare provider.

As for the "hole" you mentioned, it’s possible that this area may still be healing and could close on its own, especially if there is no ongoing drainage of fluid. However, if it remains open and does not show signs of healing, it might require further intervention. In some cases, a healthcare provider may recommend a minor surgical procedure to clean the area and close it properly, ensuring that it heals without complications.

In terms of care for the wound, here are some general recommendations:
1. Keep the Area Clean: Gently clean the wound with mild soap and water. Avoid scrubbing the area, as this can irritate the skin and delay healing.

2. Moisturize: Keeping the wound moist can promote healing. If your healthcare provider approves, you may use a silicone gel or ointment specifically designed for wound care.

3. Avoid Irritants: Be cautious with any products you apply to the area. If you have a history of keloids, it may be wise to avoid harsh chemicals or treatments until you have consulted with a dermatologist or your surgeon.

4. Monitor for Signs of Infection: Watch for increased redness, swelling, warmth, or discharge. If you notice any of these signs, contact your healthcare provider promptly.

5. Follow Up: It’s essential to have regular follow-up appointments with your surgeon or dermatologist to monitor the healing process and address any concerns. They can provide tailored advice based on your specific situation.

In conclusion, while it’s possible that the area may heal on its own, it’s crucial to keep a close eye on it and consult with your healthcare provider if you have any concerns. They can assess the wound and determine whether further treatment is necessary. Remember, every healing journey is unique, and your healthcare team is there to support you through it.

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