Hardness in Healing Wounds: When to Seek Further Medical Help

There is a foreign object in the sutured wound?

Hello, doctor.
I injured my right middle finger and received four stitches.
The stitches were removed before the New Year, and the wound has healed.
However, there is a hard lump inside the healed wound.
It feels slightly painful when pressed.
Pressing with my nail is very painful, and extending my palm or shaking my hand causes a tingling sensation.
I visited a surgeon during this time (I think he was a rather unprofessional doctor...).
I won’t go into details, but I remember that the doctor asked me, "What if I told you it would never heal?" I was quite upset at that moment; how could a doctor be so irresponsible? In the end, he only prescribed a softening agent for me to apply and told me to come back in a few weeks...
(but it still hasn't improved, which is very troublesome for my work).
I would like to ask what these symptoms might indicate, which specialist I should see, and if there is still hope for recovery...
(that dreadful doctor has left me feeling anxious).

Nan zi han, 20~29 year old female. Ask Date: 2016/03/13

Dr. Li Zhonghuai reply Surgery

Hello! First, let's confirm if the wound has healed.
Is there any abscess? If not, it is possible that there is a layer of sutures inside, which may be absorbed slowly or not at all in some patients.
Another possibility is hypertrophic scarring, which can be treated with topical steroids.
It's important not to scratch the area excessively, as it will gradually improve.
However, some individuals may have a predisposition that prevents the scar from resolving, and even steroid injections may not be effective.
In such cases, surgical revision of the scar may be necessary, but the issue is that the scar can recur, leading to itching and pain, which prompts scratching and stimulates fibroblasts, resulting in a vicious cycle.
Using immunosuppressive ointments can also have many side effects.
Wishing you a speedy recovery! Changhua Hospital cares about you!

Reply Date: 2016/03/13

More Info

Hello! It sounds like you are experiencing some complications following your finger injury, and I understand how concerning this can be. Based on your description, it seems that you may be dealing with a few potential issues related to the healing process of your wound.

Firstly, the hardness you feel beneath the skin of your healing wound could be due to scar tissue formation. When a wound heals, the body produces collagen to repair the damaged tissue, which can sometimes lead to the formation of fibrous tissue that feels harder than the surrounding skin. This is a normal part of the healing process, but in some cases, excessive scar tissue can lead to discomfort or restricted movement, which might explain the pain and tingling sensations you are experiencing when you apply pressure or try to use your hand.

The pain you feel when pressing on the area or when using your hand could also indicate that there is still some inflammation present. Inflammation is a natural response to injury, but if it persists, it can lead to chronic pain and discomfort. Additionally, if you are experiencing numbness or tingling, this could suggest that there might be some nerve involvement, possibly due to swelling or scar tissue pressing on the nerves in the area.

Given your ongoing symptoms and the impact they are having on your daily life and work, it would be advisable to seek further medical evaluation. You should consider visiting a hand specialist or an orthopedic surgeon who specializes in upper extremity injuries. They can perform a thorough examination and may recommend imaging studies, such as an ultrasound or MRI, to assess the soft tissue and determine if there are any underlying issues that need to be addressed.

In terms of treatment, if the hardness is indeed due to scar tissue, physical therapy may be beneficial. A physical therapist can provide you with exercises and techniques to help improve mobility, reduce stiffness, and manage pain. They may also use modalities such as ultrasound therapy or massage to help soften the scar tissue and promote healing.

If inflammation is a significant factor, your doctor may recommend anti-inflammatory medications or corticosteroid injections to help reduce swelling and pain. It's essential to communicate openly with your healthcare provider about your symptoms and concerns, especially if you feel that your previous consultation did not adequately address your issues.

In summary, while it is common to experience some hardness and discomfort after a wound has healed, persistent pain, numbness, and functional limitations warrant further investigation. Seeking a second opinion from a specialist can provide you with a clearer understanding of your condition and the appropriate steps to take for recovery. Don't hesitate to advocate for your health and well-being; you deserve to have your concerns taken seriously and to receive the care you need.

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