Unhealed Surgical Stitch Wound: Is Another Surgery Necessary?

Surgical wound suture removal site?

Hello doctor, I had surgery for a pilonidal cyst on April 10 at a dermatology hospital.
The suture sites have not healed properly, and there have been small blood stains the size of mung beans on the dressing.
It has been almost a month, and the puncture holes still haven't healed.
The surgeon mentioned that I may need another surgery to clean the wound.
Over the past two days, the puncture holes have not shown any blood stains, but they still haven't healed.
Doctor, do I need another surgery?

Xiao Xin, 30~39 year old female. Ask Date: 2022/04/16

Dr. Chen Bingze reply Surgery

Hello, yes.
If a wound is not healing for a long time, it is indeed necessary to consider debridement before closing the wound again.

Reply Date: 2022/04/16

More Info

It sounds like you are dealing with a challenging situation regarding your surgical wound. Based on your description, it seems that you had a procedure for a pilonidal cyst on April 10, and now, nearly a month later, the stitch holes are not healing properly. You mentioned that there has been some bleeding, and your surgeon has suggested the possibility of a second surgery to clean the wound.

To address your question directly: whether or not another surgery is necessary depends on several factors, including the condition of the wound, the presence of any infection, and how well the tissue is healing. Here are some considerations:
1. Wound Healing Process: Normally, surgical wounds should begin to heal within a few days to weeks. If the stitch holes are still open and not healing after a month, it may indicate an underlying issue. Factors that can affect healing include infection, poor blood supply to the area, or tension on the wound edges.

2. Signs of Infection: The presence of blood or drainage from the stitch holes could suggest an infection. Signs of infection include increased redness, warmth, swelling, and pain around the area, as well as fever. If you notice any of these symptoms, it is crucial to inform your healthcare provider.

3. Assessment by a Surgeon: Since your surgeon has already indicated the possibility of a second surgery, it would be wise to follow their advice. They can assess the wound more thoroughly, possibly using imaging or a physical examination to determine if there is any necrotic tissue or abscess that needs to be addressed.

4. Non-Surgical Options: In some cases, if the wound is not infected and there is no significant tissue loss, your surgeon may recommend conservative management, such as keeping the area clean, applying appropriate dressings, and monitoring the wound for signs of healing. However, if there is a significant delay in healing or signs of infection, surgical intervention may be necessary.

5. Potential Complications: If the wound does not heal properly, it could lead to complications such as chronic wounds, increased scarring, or even the need for more extensive surgical procedures in the future. Therefore, timely intervention is essential.

6. Follow-Up Care: Regardless of whether you undergo another surgery or not, it is important to have regular follow-ups with your healthcare provider. They can guide you on wound care, signs to watch for, and when to seek immediate medical attention.

In conclusion, while it is possible that another surgery may be necessary to clean the wound and promote healing, the final decision should be made in consultation with your surgeon. They will have the best understanding of your specific case and can provide tailored recommendations based on their assessment. Be sure to communicate openly with your healthcare team about your concerns and any changes you observe in your wound.

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