Wound Care Question - Stitches removed, wound re-opened
I just got my stitches removed by the practice nurse but I guess it was too early. The wound looked healed so I took a shower when I got home and the wound opened back up again. They won't restitch so I'm back to square one.
The wound is not bleeding but it's gaping quite a bit. I went back and they put some steristrips on to keep the edges together but I'm wondering if it will heal fine with steristrips?
I'm not sure if steristrips work well on old wounds. Should I leave the strips on or let the wound heal by itself? I'm worried about the scar it will leave.
I've had them before. Last time they put them on I took them off as soon as I came home. It worries me that I can't see the wound and I need to know what's going on underneath the strips. That's why I prefer stitches so I can regularly check on the wound and see how well it is healing, but it's too late for them now.
I need to be sure that the wound will heal fine with steristrips even though it's an old wound.
I bought some extra steristrips at the chemist in case I feel the urge to peel them off but I don't want to.
This morning when I woke up I noticed that two strips came off and part of the wound had re-opened again. I immediately replaced the strips and closed the wound again. Also there is a clear yellowish fluid coming out of the wound but I believe that this is normal.
Yep, that fluid is a normal part of healing. If it is still opening I'd go to the hospital, tell them what happened and that it's been closed with steri-strips since and they may then re-stitich it. In the future if a wound re-opens after the stitches have been taken out then get down to a hospital/ MIU/ Walk-In Centre and get it stitched back up again. If it was previously stitched there is no reason why not (though they may want to cut some of the tissue at the edges away) but it would need to be covered by a dressing for all the time that it is open.
I went to the hospital last night to let a doctor take a look at my wound and maybe getting it restitched. After waiting for more than an hour it was my turn and he asked what happened.
I explained it was an older wound that had been stitched before, re-opened and closed with steristrips. He said, well lets take a look, he yanked off all the steristrips, looked like 5 seconds at it and said, oh no, there is absolutely no way we are going to restitch this He cleaned it up, put new steristrips on it and send me on my way.
I am so frustrated right now because he could have told me that in de first place instead of ripping off all the steristrips. Because now I'm back to square one again and the wound healing process has to start over.
He probably needed to look at it to make sure. Often it's not the time that a wounds been open but more how it looks that means whether you can have stitches or nor. Another thing that 'may' help to keep strips in place is to cover the wound with something plastic whilst you do this but spray an invisible plaster thing over it. This will hopefully stick them down well. I say cover the wound up as it isn't a wound that this would help and it would really hinder and slow down its recovery and therefore I'd make sure you cover the wound with something waterproof, spray it on so it covers the edges of the strips and then take the plastic or whatever off the wound but make sure none of it goes into the wound before the spray dries (which is quite quick), it's just even with small wounds they can slow down healing. It's not absolutely devastating if you get some in. I know it is sometimes used routinely once a wound is closed to apply that and they've all healed fine but it wouldn't be great in your case as it's unlikely you'll get the edges totally touching.
But yeah, I agree with Kim regarding the timing. I'd personally leave the steri-strips in place for 10+days, maybe a bit more, just to make sure it's fine. If the stitches were in for 10days then I'd maybe leave it for 14days. The reason being that the outside of a wound can look healed when the inside really isn't and the inside is at the end of the day what keeps it closed which is probably why you've had this problem.
Just keep your eye out for signs of infection and I'd also keep the wound and strips covered with a dressing and obviously not get them wet. Change the dressing every couple of days, more often if there is a lot of discharge, twice a day if it becomes infected and if it does become infected see a doctor asap and removing the steri-strips is likely to be better in that situation as it stops pus getting stuck under the skin.
And, if you're not already trying it then I'd also suggest Kim's way of having a strip parallel to the wound on either side to hold the rest in place more securely. This doesn't necessarily have to be a steristrip neither if its not going over a wound and so could just be a strip of medical tape and just make it so it looks like ####### all the way along.
Today I took off all the steristrips because they wouldn't stay on. I've tried what Kim suggested but I guess there is too much tension on the wound.
Because stitches and steristrips are not an option anymore I've decided to let the wound heal by itself. It seems like I have no other choice, I've tried.
This will leave a much bigger scar obviously but I've been reading a bit about second intention healing on the internet and it says that the wound will contract during the healing process and become 40 to 80% smaller in size. Is this true?
It depends on how it gets looked after and really that is looking over the long time and presuming it doesn't get infected. Really, as it isn't infected at the moment I urge you to buy Hydrocolloid dressings (though keep it covered in the meantime with any sterile, non-stick dressing). These REALLY make a huge difference and can massively improve would healing. They are more expensive than normal dressings though they can remain in place for up to 7days (and have no benefit if changed any more often than every 3days). They are also waterproof and stick really well. However, as I haven't seen the wound it would be a good idea to talk to a pharmacist. It may be that it is a bit big for one of these, in which case using normal non-stick dressings or a dressing known as Allevyn and putting hydrogel (Intrasite being one tradename. Savlon Advanced Healing Gel I think it is called is another) on the wound may also be an option. It also depends obviously what size dressings the pharmacist has behind the counter as they only have a small proportion of the more specialised dressings they sell out on the shelves.
Hydrocolloid dressings from where I am would be your best bet. Other than that then Hydrogels or Alginate dressings may be other good ideas (though alginate dressings probably are only available in the same size dressings as hydrocolloid ones and may not help as much whereas Hydrogels you can use with most dressings; they're probably best with Allevyn which you can get a waterproof adhesive version of and they come in quite large sizes.) I would stray away from using antiseptics really. Make sure you keep it clean.
Also, if you're using any of these types of dressings/ gels and it starts to show signs of infection (becoming more painful/ the surrounding area getting red or swollen) then you need to remove the dressing as they are great for skin cells and to gro in and for granulation tissue to allow really good secondary intention BUT they also give a really good environment for bacteria too.