How to care for this?
 

Hiya, just wanted some advice on what to do regarding a wound.

I went to a+e today to get a wound over 2 cm wide, about 7cm long and 1cm or so deep sorted but the nurse said there was not enough skin and it was too wide to get it to close. So instead of the stitches I was expecting she just put a jelonet (or whatever its called) thing on it, put a non stick dressing on it and wrapped it with a roll of gauze and told me it wouldn't need changing until the end of the week. Here's the problems:

1) I know she is the nurse not me but the doctor before seemed to think it would definitely be stitched and it seems a bit weird to just leave the wound as it is. Is there anything I can do to help healing?

2) Just got changed and blood has already gone all the way through the gauze. She was adamant it wouldn't need changing until the end of the week. Should I just leave it? Is this ok? I can't get jelonet to change it anyway.

Thanks

Emma

I think it's really strange that she didn't stitch it up. "Too wide" is a really stupid excuse, especially considering that nurses stitch or staple much larger wounds all the time. I'd suggest calling your doctor or NHS for advice. If the wound is still bleeding rather heavily, that's a problem, even if just because of the mess.

If it's still bleeding heavily then get it looked at as soon as you can. They still may be able to stitch it depending how long it is since you did it and if it needs that/ if it can be done. If it is bleeding through the gauze then yes, this will need to be replaced. Jelonet is a material that creates like a scaffold for cells to bridge across the wound which is why she will have used this; it will help some skin to grow rather than the whole area just replaced by scar tissue.

That sounds like a pretty nasty wound and if the doctor said it needed stitching then it probably did but, did he actually touch the wound and try to bring the edges together? It could be that she did and realised that it is a bit wide. However, they can help to loosen the skin to allow for this but that's a bigger job then just sticking a few putting a few stitches across the wound. If a wound gets a bit wide, the proteins in the skin 'shrink' and that's what causes it to gape. Because of this, it can often be hard to close a wide wound as they have to pull against those contracted collagen proteins. If you pull too tight and stitch it up it can cause the wound not to heal as too much tension on a wound will reduce healing/stop it all together and this may have been her train of thought if she struggled to get the wound together.

As it is a bank holiday today, I'd suggest finding and going to your local walk-in centre. If there isn't one of those in your area then maybe try the a+e where you went to and tell them it's still bleeding or try a local Minor Injuries Unit (kind of like a mini a+e that deal with things like cuts, broken bones, sprains and have a low witing time). The dressing needs changing really and I think because it's so soon after you had it put on and you have bled through it then it should really be checked again , especailly as the doctor that saw you adviced that it got stitched and at that size, stitching may be the best option, though it does depend where the wound is and the direction of it to how simple that would be.