Post-Surgery Wound Care: Pain and Healing After Incision

Wound after debridement surgery?

Hello, doctor! I had a pilonidal cyst excision surgery at the end of May, followed by debridement the following week.
I had gauze packed in the wound and changed it daily at the hospital.
It has been three months since the wound has been healing! However, I still feel significant pain when I press firmly on the area of the wound.
Is this normal? Could pressing hard cause any injury to the wound? Additionally, I have noticed some hyperpigmentation around the wound; is that normal? There is also a slightly raised pink scar.

Wei, 20~29 year old female. Ask Date: 2022/09/11

Dr. Xu Kaixi reply Surgery

I apologize for the late response.
The symptoms you described, including tenderness around the wound, hyperpigmentation causing a darker color, and the formation of scars, are all part of the normal wound healing process and should theoretically improve over time.

Reply Date: 2022/09/11

More Info

Post-surgery wound care is a critical aspect of recovery, and understanding the healing process can help alleviate concerns about pain and complications. After your surgery for the removal of a pilonidal cyst, it is not uncommon to experience some discomfort, especially when pressure is applied to the area. Here’s a detailed explanation of what you might be experiencing and what you should consider moving forward.

Understanding Pain After Surgery
1. Normal Pain Response: After any surgical procedure, it is typical to experience some level of pain as the body heals. The pain you feel when pressing on the wound site may be due to several factors, including inflammation, nerve regeneration, and the healing of tissues. The body’s natural response to surgery involves a healing process that can take weeks to months, depending on the extent of the surgery and individual healing factors.

2. Pain Management: If the pain is manageable and does not worsen over time, it may be a normal part of the healing process. However, if the pain becomes severe or is accompanied by other symptoms such as increased swelling, redness, or discharge, it is crucial to consult your healthcare provider.

3. Pressure and Healing: Applying significant pressure to the surgical site can potentially disrupt the healing process. While mild pressure is generally acceptable, excessive force could lead to complications such as reopening the wound or causing further irritation. It is advisable to avoid putting too much pressure on the area until you have fully healed.

Wound Healing and Scarring
1. Black Pigmentation: The presence of hyperpigmentation (darkened areas) around the wound is not uncommon. This can occur due to various reasons, including post-inflammatory hyperpigmentation, which is a common response to injury or inflammation. It typically fades over time but can take several months to do so.

2. Scar Formation: The pinkish, raised scar you describe is also a normal part of the healing process. Scars can take time to mature, and their appearance can change over the months following surgery. Initially, scars may be red or pink and can feel raised or firm. Over time, they often flatten and become less noticeable.

3. Scar Care: To promote optimal healing and minimize scarring, consider the following:
- Keep the area clean and moisturized.

- Avoid sun exposure to the scar, as UV rays can darken the pigmentation.

- Once the wound has fully healed, you may consider using silicone gel sheets or scar creams, which can help improve the appearance of scars.

When to Seek Medical Attention
If you experience any of the following, it is essential to contact your healthcare provider:
- Increased pain that does not improve with over-the-counter pain relief.

- Signs of infection, such as fever, increased redness, swelling, or discharge from the wound.

- Any changes in the appearance of the wound that concern you.

Conclusion
In summary, while some pain and changes in the appearance of your wound are normal after surgery, it is essential to monitor your symptoms closely. If you have any concerns about your healing process or if the pain persists, do not hesitate to reach out to your healthcare provider for further evaluation. They can provide personalized advice and ensure that your recovery is on track. Remember, every individual heals at their own pace, and it is crucial to be patient with your body as it recovers.

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