Post-Surgery Urology Concerns: Wound Healing and Recovery Questions

I'm sorry, but I cannot assist with that?

Hello Doctor, I'm back.
My surgeon decided to reopen the incision on September 16 to clean out the blood clots and re-suture it (using nylon sutures), and then I had the stitches removed on the 26th (the surgeon indicated that there were no complications and I didn't need a follow-up appointment).
Now it's the 30th (it's inconvenient to see a doctor outside the camp), and I have some questions to ask:
1.
About two days after the stitches were removed, I started to notice scabs and dead skin peeling off.
After the peeling, I found a spot about 0.5 cm wide that hasn't healed (the edges of the wound are not together, and upon closer inspection, I can see red tissue in the middle).
It doesn't hurt, there's no bleeding or pus, and it occasionally itches.
How should I manage this wound?
2.
On the other side, there's a wound about 1 cm long.
After the scab and dead skin fell off, there was still a layer of scab in the middle.
Recently, that layer of scab came off, and I noticed that the wound hasn't healed well; it's a bit moist.
After a day, it scabbed over again, but the scab is quite thick, and the edges of the skin are not together, resembling n_n (where n represents skin and _ represents scab).
Is it okay to leave this wound alone?
3.
A few days after the stitches were removed, I noticed swelling around the base of my penis.
The surgeon said this is normal and not a concern.
However, the areas where the wounds have healed well all have a noticeable indentation in the middle.
Is this normal? Will it disappear after the swelling subsides?

24-Year-Old Newbie, 20~29 year old female. Ask Date: 2022/09/30

Dr. Du Shixi reply Urology

Hello,
1.
About two days after my stitches were removed, I started to notice scabs and dead skin peeling off.
After the peeling, I found a wound approximately 0.5 cm that hasn't healed (the two sides of the wound are not together, and upon closer inspection, there is red tissue in the middle).
It doesn't hurt, there is no bleeding or pus, and it occasionally itches.
How should I manage this wound? --> If it's not wide, it will heal on its own.
2.
On the other side, there is a wound about 1 cm long.
After the scab and dead skin fell off, there was still a layer of scab in the middle.
Recently, that layer of scab fell off, and I noticed that the wound hasn't healed well.
The wound is slightly moist, and after a day, it scabbed over again, but the scab is very thick, and the skin on both sides hasn't come together, resembling n_n (where n represents skin and _ represents scab).
Should I just leave this wound alone? --> Keep it clean and dry.
3.
A few days after the stitches were removed, I noticed swelling around the base of my penis.
The surgeon said this is normal and not a problem.
However, the unhealed wound looks different from the other healed wounds, as I can clearly see a depression in the middle.
Is this normal? Will it disappear after the swelling subsides? --> It will recover, but it will take time.
The scar will gradually fade over a few months.
Take care and wish you good health.

Reply Date: 2022/09/30

More Info

Post-surgery recovery, particularly in urology, can often raise concerns regarding wound healing, potential complications, and the overall recovery process. Based on your detailed description, it seems you are experiencing some common post-operative issues that can arise after surgeries involving the urogenital area. Let's address your questions one by one.

1. Wound Healing and Management of Non-Healing Areas: It is not uncommon for surgical wounds to take time to heal completely. The presence of a small area (0.5 cm) that has not yet healed, especially if it is not painful, does not necessarily indicate a problem. The fact that it is occasionally itchy is a good sign, as itching often indicates healing. For this area, it is crucial to keep it clean and dry. You can gently wash it with mild soap and water, pat it dry, and consider applying a thin layer of antibiotic ointment if recommended by your doctor. Avoid picking at the scab, as this can lead to infection or delayed healing. If you notice any signs of infection (increased redness, swelling, warmth, or discharge), you should seek medical attention.

2. Management of the Other Wound: The 1 cm wound that remains moist and has not healed properly may require more attention. If it is forming a deep scab and the edges are not coming together, it is essential to monitor it closely. Keeping the area clean is paramount, and you may want to apply a non-stick dressing to protect it while it heals. If the wound continues to show signs of not healing or if it becomes increasingly moist or painful, a follow-up with your healthcare provider is advisable. They may need to assess whether there is any underlying issue, such as infection or inadequate blood supply to the area.

3. Swelling and Appearance of the Surgical Site: Swelling around the surgical site, especially near the ties or sutures, is a common occurrence post-surgery. It is often due to inflammation as the body responds to the surgical trauma. The appearance of the skin, including any indentations or irregularities, can be concerning, but it is important to remember that healing can take time. As the swelling decreases, the skin may appear more normal, and any indentations may fill in as the tissue heals. However, if the swelling persists or worsens, or if you experience increased pain, it is crucial to consult your doctor.

In general, post-operative care in urology should include:
- Regular Monitoring: Keep an eye on your wounds for any changes. Document any concerns you have, such as increased pain, changes in color, or unusual discharge.

- Hygiene: Maintain good hygiene around the surgical site to prevent infection. This includes gentle cleaning and avoiding any irritants.

- Follow-Up Care: Even if your doctor indicated that no follow-up was necessary, if you have concerns, do not hesitate to reach out. It is better to be cautious, especially with surgical wounds.

- Pain Management: If you are experiencing discomfort, over-the-counter pain relief may be helpful, but consult your doctor for recommendations tailored to your situation.

Lastly, remember that healing is a process that varies from person to person. Patience is key, and if you have any doubts or concerns, reaching out to your healthcare provider for guidance is always a good decision. They can provide personalized advice based on your specific circumstances and ensure that your recovery is on track.

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