Post-Accident Wound Care: Expert Advice on Stitch Management

After a car accident on the night of December 11, how to properly care for sutures?

Hello Dr.
Lee, I had a car accident on December 11, resulting in an injury above my ankle.
I received nine stitches in the emergency room.
The photo below was taken on the morning of December 16 when I changed the dressing myself.
https://lurl.cc/6wwvz I have consulted two doctors (since there was no surgical clinic yesterday) and I am unable to change the dressing on my own, so the hospital referred me to family medicine.
The two doctors provided completely different treatment recommendations, so I would like to ask for your opinion.

On December 13, the doctor I consulted helped to drain some tissue fluid and advised me that if I were to change the dressing myself (he prescribed an ointment), I must keep it dry and try to avoid moving around as much as possible.
In the photo, the doctor I saw on the evening of December 15 noted some darkening and redness at the suture site, so he provided me with two bottles of dressing to change at home (to be applied wet to the suture site) and suggested adding heat and massage to promote blood circulation.
He advised me to return for a follow-up on Monday, and if there is no improvement, I may need to undergo debridement.

I am very worried; will debridement be more painful in the future? Or would it be better to re-suture? Therefore, I would like to know how to properly manage the injury shown in the photo.
Thank you very much for taking the time to read my question.

Masumi, 30~39 year old female. Ask Date: 2023/12/16

Dr. Li Zhonghuai reply Surgery

Hello! The photo appears to show cellulitis, and the blood circulation is not very good.
After changing the dressing, clean the area with sterile saline solution; of course, the tissue fluid inside should be drained, apply ointment, and cover it with a gauze.
The wound should not come into contact with tap water.
Antibiotics should be taken, and elevating the leg while sleeping will help reduce swelling more quickly, and the cellulitis will gradually improve.
However, if the cellulitis does not improve, debridement may be necessary before suturing.
Take care! Changhua Hospital cares about you!

Reply Date: 2023/12/16

More Info

After an accident, proper wound care is crucial for healing and preventing complications. Given your situation, where you have a stitched wound on your ankle, it’s important to follow a structured approach to care for the injury. Here’s a comprehensive guide based on your description and general medical knowledge.

Immediate Wound Care
1. Keep the Wound Clean and Dry: Initially, it’s essential to keep the wound clean and dry. If your doctor has advised you to keep it dry, avoid soaking the area in water (like baths or swimming) until it has healed sufficiently. You can use a waterproof bandage if you need to shower.

2. Changing Dressings: When changing the dressing, ensure that you wash your hands thoroughly to prevent introducing bacteria. Use sterile gauze and follow the instructions provided by your healthcare provider. If you were given a specific ointment, apply it as directed.
3. Observe for Signs of Infection: Monitor the wound for any signs of infection, which include increased redness, swelling, warmth, pus, or a foul odor. If you notice any of these symptoms, contact your healthcare provider immediately.

Managing Fluid Accumulation
You mentioned that there was some tissue fluid accumulation. This is not uncommon after surgery or injury. If your doctor has advised you to express this fluid, do so gently and with clean hands. If the fluid continues to accumulate, it may require further evaluation by a healthcare professional.

Pain Management
Pain management is also a critical aspect of recovery. Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage discomfort. However, follow your doctor's recommendations regarding medication, especially if you have any underlying health conditions.

Activity Level
Your doctors have advised limiting movement to promote healing. It’s important to follow this advice. Walking or putting weight on the injured area too soon can lead to complications, such as delayed healing or increased pain. Use crutches or a brace if recommended.

Follow-Up Care
You mentioned that you have follow-up appointments scheduled. It’s crucial to attend these appointments, as your doctor will assess the healing process and determine if further interventions are necessary, such as debridement (cleaning of the wound) or additional stitches.

Concerns About Debridement
If your wound requires debridement, it may sound daunting, but it is a common procedure to remove dead or infected tissue to promote healing. While it can be uncomfortable, local anesthesia is typically used to minimize pain during the procedure. It’s essential to discuss your concerns with your healthcare provider, as they can provide reassurance and explain the process in detail.

Long-Term Care
Once the stitches are removed, continue to care for the area by keeping it clean and moisturized. Scarring is a common concern after stitches, but proper care can minimize this. Using silicone gel sheets or ointments may help reduce scar formation.

Conclusion
In summary, follow your healthcare provider's instructions closely regarding wound care, activity levels, and follow-up appointments. Keeping the wound clean and dry, managing pain, and monitoring for signs of infection are vital steps in your recovery. If you have any doubts or concerns, don’t hesitate to reach out to your healthcare provider for clarification and guidance. Your health and recovery are the top priorities, and open communication with your medical team is key to a successful healing process.

Similar Q&A

Managing Post-Surgery Wound Care After Traumatic Lacerations

Hello, doctor. I sustained a laceration from a car accident, and the first hospital did not handle it well, so I went to another hospital for debridement and suturing. The surgeon debrided and sutured two layers, and the stitches were removed on the eighth day. However, now, a we...

Dr. Zhou Hongzhang reply Plastic Surgery
This issue is quite complex and requires an actual examination of the wound to understand fully. It is recommended to consult a nearby plastic surgery outpatient clinic. Thank you.

Post-Stitch Care: Managing Wound Healing After Surgery

Two weeks ago, I cut the palm of my hand with a utility knife and received three stitches. Today marks five days since the stitches were removed, but the epidermis does not appear to have healed. It looks red and white and continues to ooze (not in a dry state), and I also experi...

Dr. Lü Mingchuan reply Plastic Surgery
Wound assessment can be performed in an outpatient setting.

Managing Post-Surgical Scarring and Persistent Headaches After Trauma

Last year, I had a car accident that resulted in a laceration on my head that required stitches. However, I frequently experience headaches, and sometimes the area around the wound shows signs of inflammation resembling blisters. When these blisters burst, clear fluid oozes out. ...

Dr. Huang Junxiong reply Surgery
Hello: Based on your description, it is possible that there is an issue with wound healing and a mild infection. I recommend that you visit a hospital for a physician to examine the wound in person for proper treatment. The treatment may not necessarily require re-suturing; it de...

Post-Accident Knee Care: Recovery Tips After Stitches Removal

Hello Doctor: It has been over two weeks since the car accident. I had an X-ray at the hospital, and they said there were no abnormalities. My right knee has a 10x10 cm abrasion and a 3 cm sutured wound above it, which the nurse mentioned was deep enough to see the fat layer. The...

Dr. Zhang Shuhao reply Surgery
1. If the X-ray shows no fractures, you can still move, and the wound has healed and stitches have been removed, then it is likely just a contusion of the muscles and soft tissues. During the acute phase, ice therapy and rest are recommended. If there is minimal pain now, gentle ...