The wound has scarred and formed a scab?
Hello, doctor.
It has been almost 1.5 months since I underwent excision and suturing of a pilonidal sinus.
After the surgical wound scabbed over, I have been using a non-adhesive dressing for nearly 3 weeks, changing it once a week.
Yesterday, when I changed to a new dressing, I noticed a small area (1 cm long and 0.3 cm wide) with new scabbing, but it is already dry with no drainage or bleeding.
Should I temporarily stop using the non-adhesive dressing and continue to disinfect with saline solution and Betadine twice a day, followed by applying Neomycin ointment and covering it until the scab falls off? Is it necessary to return for a follow-up appointment for the doctor to examine this situation?
A Xin, 30~39 year old female. Ask Date: 2022/07/04
Dr. Zhang Shuhao reply Surgery
If the wound is dry with no drainage or bleeding, you can choose not to apply adhesive tape and observe it for two to three days.
After simple disinfection, there is no need to apply ointment.
If the wound remains free of redness, swelling, or drainage, you can continue using the adhesive tape.
During this period, avoid large movements that may strain the back to allow the wound to rest.
If there is any drainage or if the skin edges of the wound separate, you should return for an earlier follow-up appointment for evaluation.
Reply Date: 2022/07/04
More Info
Managing scabs and scarring after surgical wound healing is an important aspect of post-operative care. It’s great to hear that you are being proactive about your recovery following your surgery for the removal of a pilonidal sinus. Based on your description, it seems that you are on the right track, but let’s delve deeper into the management of your wound and the considerations you should keep in mind.
Firstly, it’s normal for surgical wounds to go through various stages of healing, including the formation of scabs. Scabs form as part of the body’s natural healing process, protecting the underlying tissue as it regenerates. The fact that you have a small area of new scabbing that is dry and not producing any discharge or blood is a positive sign, indicating that the wound is healing properly.
Regarding the use of adhesive dressings like the "免縫膠帶" (non-stitch tape), it is generally advisable to continue using them until the wound is fully healed and any scabs have fallen off naturally. These dressings can help protect the area from external irritants and promote a moist healing environment, which is beneficial for minimizing scarring. However, if you notice that the area is becoming too moist or if the dressing is causing irritation, it may be appropriate to take a break from it.
In your case, since you have a small area of new scabbing, it might be wise to continue applying the adhesive tape to protect that area, especially if it is in a location that may be subject to friction or irritation from clothing or movement. If you decide to stop using the tape, ensure that you are still keeping the area clean and protected. Cleaning the wound with saline solution and applying a topical antibiotic ointment like Neosporin is a good practice. This will help prevent infection and promote healing.
As for whether you need to return to your doctor for a check-up, it largely depends on how you feel about the healing process. If the area appears to be healing well, with no signs of infection (such as increased redness, swelling, warmth, or discharge), and you are not experiencing any unusual pain, you may not need to go back. However, if you have any concerns—such as changes in the appearance of the wound, increased pain, or if the scabbing does not resolve—you should definitely reach out to your healthcare provider for further evaluation.
In summary, continue to monitor the wound closely. Maintain good hygiene by cleaning it with saline and applying antibiotic ointment. If the scab falls off naturally and the skin underneath appears healthy, you can stop using the adhesive tape. However, if you have any doubts or if the wound does not seem to be healing as expected, do not hesitate to consult your doctor. Remember, proper wound care is crucial not only for healing but also for minimizing scarring in the long run.
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