Delayed Wound Healing After Surgery: Causes and Solutions

Delayed wound healing after surgery?

Hello, Director Ko:
Several years ago, I developed a pimple, colloquially referred to as a "nail" in Taiwanese, located above my buttocks near the groin.
I used to pop it myself, but it would recur after a few months.
Last year, I felt something was off and decided to undergo surgery to remove it.
Three months ago, I had the procedure done, but since then, the wound has not fully healed.
It keeps healing for a few days and then reopens, which has been quite distressing.
It has been three months since the surgery, and I recently had a follow-up appointment with the surgeon.
However, during the visit, the wound appeared to be healing, so the doctor did not examine it further, only advising me to rest well.

Although the wound has not reopened in the past few days and there are no signs of pus, I have started experiencing pain in the area around the wound, and the scar from the sutures appears slightly swollen.
I would like to ask you, is this situation common? Could it be due to the depth of the wound and incomplete internal healing, or are there any other possible explanations?

Xiao Wang, 30~39 year old female. Ask Date: 2016/01/08

Dr. Ke Fangxu reply Surgery

Wounds in the groin area, due to their proximity to the midline, are prone to poor healing after surgery.
However, if three months have passed since the surgery and the wound has still not healed, it is important to investigate the underlying issues.
If there is no diabetes or other conditions that affect wound healing, one should consider whether the initial surgery did not achieve complete excision.
In males, there is a possibility of developing a "pilonidal cyst" in the groin area.
If the excision was not extensive enough, recurrence is likely.
It is advisable to consult a physician for examination the next time swelling or pain occurs, as this increases the likelihood of making an accurate diagnosis.

Reply Date: 2016/01/08

More Info

Delayed wound healing after surgery can be a frustrating and concerning issue for many patients. Your experience with the recurring wound healing problems following the excision of a cyst or abscess in the groin area is not uncommon, and there are several factors that could contribute to this situation.

First, it is important to understand that wound healing is a complex biological process that involves several stages: hemostasis, inflammation, proliferation, and remodeling. Each of these stages must occur in a timely and effective manner for the wound to heal properly. If any of these stages are disrupted, it can lead to delayed healing or even wound dehiscence (the reopening of a wound).

Several factors can influence wound healing, including:
1. Infection: Even if there are no visible signs of infection (such as pus or redness), a subclinical infection can still impede healing. Bacteria can form biofilms that are difficult to detect and can prevent the wound from healing properly.

2. Tissue perfusion: Adequate blood flow is essential for delivering nutrients and oxygen to the wound site. Conditions that impair circulation, such as diabetes or peripheral vascular disease, can significantly delay healing.

3. Wound depth and size: Deeper wounds generally take longer to heal than superficial ones. If the wound was extensive or involved deeper layers of tissue, it may take more time for the body to regenerate the necessary tissue.

4. Underlying health conditions: Chronic illnesses, such as diabetes, obesity, or autoimmune disorders, can negatively affect the body’s ability to heal. Medications that suppress the immune system or affect blood flow can also contribute to delayed healing.

5. Nutritional status: Proper nutrition is vital for wound healing. Deficiencies in protein, vitamins (especially vitamin C and vitamin A), and minerals (like zinc) can hinder the healing process.

6. Mechanical stress: If the wound area is subjected to tension or movement, it can lead to reopening or delayed healing. This is particularly relevant in areas like the groin, where movement is frequent.

Given your description of the wound appearing to heal only to reopen, along with pain and swelling, it would be prudent to follow up with your surgeon or a wound care specialist. They may recommend further evaluation, which could include imaging studies to assess for any underlying issues, such as abscess formation or foreign body presence.
In terms of management, here are some potential solutions:
- Wound care: Keeping the wound clean and appropriately dressed is crucial. Your healthcare provider may recommend specific dressings that promote a moist healing environment, which can enhance healing.

- Antibiotics: If there is any suspicion of infection, your doctor may prescribe antibiotics to help clear any underlying infection that could be hindering healing.

- Surgical intervention: In some cases, if a wound is not healing due to excessive tension or if there is a significant amount of dead tissue, a surgical revision may be necessary to promote healing.

- Nutritional support: Ensuring adequate nutrition can support the healing process. A diet rich in protein, vitamins, and minerals is essential.

- Monitoring and follow-up: Regular follow-up appointments with your healthcare provider can help monitor the wound's progress and make adjustments to the treatment plan as necessary.

In conclusion, while delayed wound healing can be a common issue, it is essential to address it proactively. By understanding the potential causes and working closely with your healthcare team, you can improve the chances of successful healing and minimize the risk of complications.

Similar Q&A

Understanding Delayed Wound Healing: Causes and Solutions

Hello Dr. Lee, in mid-February of this year, I sustained a deep laceration on the skin over the anterior tibia of my lower leg (almost to the bone) from a motorcycle side stand. I promptly went to the hospital for debridement and suturing. Two weeks after the stitches were remove...

Dr. Li Zhonghuai reply Surgery
Hello! This wound is difficult to heal. If there are no secretions after healing, we will monitor it conservatively. Taking vitamin B12 can promote nerve repair. Take care! Changhua Hospital cares about you!

Delayed Wound Healing After Surgery: When to Seek Further Medical Attention?

Two weeks ago, I was involved in a car accident and sustained a tibial fracture, with some comminution of the adjacent small bone, and there was a puncture wound through the skin. Surgery was performed on the day of the accident, where a plate and screws were placed. Now, two wee...

Dr. Chen Bochen reply Orthopedics
1. Comminuted fractures and open fractures typically have a slower healing process due to the nature of the wounds. 2. If there are concerns about wound infection, it is advisable to change the dressings two to three times a day. 3. If you feel that the wound is worsening, co...

Delayed Healing After Appendectomy: Concerns and Recovery Insights

Hello doctor, I would like to ask a question for my mother. It has been nearly a month since she had her appendectomy. Two weeks after the surgery, she went to another clinic to have her stitches removed. During the process, the doctor informed her that the surgeon who performed ...

Dr. Chen Jiaming reply Surgery
The wound healing status varies based on the original condition (appendicitis -> appendicitis is classified as an intra-abdominal infection), age, nutritional status, diabetes, and wound care methods, among other factors. Although it has been a month, since the doctor indicate...

Managing Non-Healing Surgical Wounds: A Case Study

On March 7, I underwent surgery for facial lipomas, resulting in five incisions. The sutures were removed on March 15. The following day, during a dressing change, I noticed that one of the incisions, approximately 2 cm in size, had a portion measuring about 0.5 cm in length and ...

Dr. Chen Ronghong reply Surgery
Hello, Yan Liu. Among the five wounds, only one has poor healing, which is more likely due to a localized infection causing inflammation. The contents of the cyst could potentially lead to a bacterial infection. Please continue using the antibiotic ointment, avoid pulling on the ...