Is it necessary to return for a follow-up and re-suture if the wound has been pulled after the stitches were removed?
Hello doctor, I had a sinus tract surgery at the Veterans General Hospital on April 20.
I returned for a follow-up appointment two weeks later to have my stitches removed.
On the way home, I accidentally pulled on the wound, causing a gap approximately 0.6 cm long and 0.4 cm wide to open up.
After six days, I changed the dressing this morning and noticed that the wound has formed a scab, with no bleeding or drainage.
Should I return for a follow-up to have the opened wound re-stitched, or should I continue to change the dressing daily and allow the wound to heal on its own?
A Xin, 30~39 year old female. Ask Date: 2022/05/09
Dr. Zhang Shuhao reply Surgery
If the incision from a pilonidal sinus surgery is directly sutured (without skin grafting), the tension will be greater.
Whether to perform debridement and re-suturing after a rupture mainly depends on two factors: 1.
Presence of infectious discharge from the wound, and 2.
Whether the wound tension is too high, which could hinder natural healing.
If the wound successfully forms a scab and there are no concerning symptoms, it can be monitored.
However, if healing is poor, it is important to return for an early evaluation.
Reply Date: 2022/05/09
More Info
Based on your description of the wound situation following your surgery, it appears that the wound has developed a small split measuring approximately 0.6 cm by 0.4 cm. Since you mentioned that the wound has formed a scab, there is no bleeding, and no drainage of tissue fluid is present, it suggests that the wound is beginning to heal on its own.
In general, whether or not to return for stitches after a wound has split open depends on several factors, including the size of the wound, the depth of the wound, the presence of infection, and the overall healing process. In your case, since the wound is relatively small and has shown signs of healing (i.e., scabbing and no active bleeding), it may not be necessary to have it re-stitched.
However, it is crucial to monitor the wound closely. Here are some considerations:
1. Signs of Infection: Keep an eye out for any signs of infection, such as increased redness, swelling, warmth around the wound, or any discharge that appears yellow or green. If you notice any of these symptoms, it would be advisable to return to your healthcare provider for further evaluation.
2. Wound Care: Continue to keep the wound clean and dry. You can use a saline solution or mild soap and water to clean the area gently. After cleaning, apply a sterile bandage to protect the wound. Changing the dressing daily or whenever it becomes wet or dirty is essential.
3. Healing Process: The body has a remarkable ability to heal itself. If the wound is not deep and has formed a scab, it is likely that it will continue to heal without the need for stitches. The scab acts as a natural barrier to protect the underlying tissue as it heals.
4. Follow-Up: If you are uncertain or if the wound does not seem to be healing properly, it is always a good idea to consult with your healthcare provider. They can assess the wound and determine if any further intervention is necessary.
5. Avoiding Strain: Since you mentioned that the wound split open due to pulling while driving, it would be wise to avoid any activities that could put strain on the area until it has fully healed. This includes heavy lifting, vigorous exercise, or any movements that might stretch the skin around the wound.
In conclusion, while it seems that your wound may not require re-stitching at this time, it is essential to remain vigilant about its healing process. If you have any doubts or if the condition of the wound changes, do not hesitate to seek medical advice. Your healthcare provider can provide the best guidance tailored to your specific situation.
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