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Does it take this long for wounds to heal?

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Ulcerative Colitis
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Posted 8/25/2010 11:29 PM (GMT 0)
 

As most of you know, I recently had colon surgery and suffered from an infection at the site of the incision. A culture was done and based on the results, I was put on a 14-day course of amoxicilin. I think the infection is gone now--no fever anymore, no vomiting. I feel great and I'm eating a normal diet. However, I've been told that since the wound was open slightly (just a few milimeters wide but about 4.5 cm deep), it has to heal from the inside out, so for the last 4 weeks I've had it packed with iodoform, changed daily, and flushed with saline. It's been five weeks since surgery and the wound depth has only decreased from 4.5 cm to 3.5 cm (keep in mind that it took 2 weeks post-surgery for the infection to resolve).  One surgeon wants to open me up completely but I'm against it.

Is it normal for wounds to take this long to heal? I'm not diabetic and have no other underlying health conditions (other than the ulcerative colitis, for which I had surgery). I'm hesitant to have the entire 1 inch incicision opened up (right now, it's just a few milimeters opening). If it heals slowly, I'm fine with it as long as it heals. My surgeon and primary care doc have counseled against having the wound opened up, but the doc at the wound care center who I see every week is pushing for it. The wound is on my abdomen, just above my belly button.

CollegeGrad85

dx with UC in 2008

colon surgery in July 2010

Week 1: Depth with tunneling

Posted 8/26/2010 2:11 AM (GMT 0)
I think it really depends on the person, the condition of the wound, where the wound is located...

I've had wounds that didn't heal for many years. I remember getting my ears pierced at 10. It wasn't until I was about 18 that I no longer had open wounds on my pierced ears. I remember the holes always sticking to the posts when I put on and took off my earrings.
Posted 8/26/2010 2:35 AM (GMT 0)
Perhaps the packing of it, and removal/changing of packing prolongs the healing? Have heard using iodine on animal wounds can delay healing... do you have to keep it packed or can you just flush it? What does the dr say?

http://www.clinicaltrials.gov/ct2/show/NCT00746109
<<Superficial skin and soft tissue abscess are frequently managed by opening them up with a procedure called "incision and drainage". It is routine practice in the United States to place packing material inside the abscess cavity after opening them up, in order to promote better wound healing and limit abscess recurrence. However, this practice has never been systematically studied or proven to decrease complications or improve healing. Patients with wound packing usually return to the emergency room or practice setting for multiple "wound checks" and dressing/packing changes which lead to missed days from work or school and utilization of healthcare resources. This procedure can often be painful and may even require conscious sedation (and the risks entailed) especially in children. With rates of superficial skin and soft tissue abscesses on the rise, and emergency room resources being stretched, it is important to determine whether packing wounds is necessary or even advantageous to patients.>>
Posted 8/26/2010 10:58 AM (GMT 0)
i had a similar prob after my reversal,afta aweek of oozin wound da surgun literlly opened up my wound with his hands, the pain was unbearable. i had a 1 1/2 inch open wound, they also said it had to heal inside out. i had a vacum put on. basically they stuffed my wound wid sponge and put a sort off vacum on which sucked the mess out. apparentaly it takes off 1/2 of the healing time off.
it was very noisy and i had a box to carry everywhere, but my nurse (hu came every 2 days to change da dressing) said he has other patients and their healing takes months wid my kind of wound and said he was facinated by the machine. if i didn't get it of the NHS i was going to hire it.
my healing took 3 weeks and it was quite painful da first 2 times wen changing it but i do believe it help to clear infection, i cud see all th gunge goin frm da wound.
so i think u shud ask if openin da wound n puttin a vacum on will be better 4 u.

hope dis helps

samie
Posted 8/26/2010 1:41 PM (GMT 0)
Were you on pred before/after your surgery? I have heard it can really slow down the healing process pretty drastically! I hope you feel better! :o(
Posted 8/26/2010 1:52 PM (GMT 0)
Thanks for the comments--the last time I was on pred was about 6-8 weeks before surgery. I intentionally stopped the pred early on so it wouldn't be a factor. I feel it's healing--I no longer have pain, discomfort, or tenderness where the wound is--in fact, I don't feel anything and wouldn't know it was even there if I didn't have the hole and the 3.5 cm deep wound that's measured weekly.

I'm somewhat afraid of having it completely opened up and made larger if it's not necessary...I'm fine with waiting it out if it's normal for a wound like this to take long to heal.
Posted 8/26/2010 1:57 PM (GMT 0)
If you were on pred before surgery your healing is going to be much slower. You won't be considered pred-free until one year of your last dose.

A wound vac might be your best option. Talk to your surgeon about it.

Sue
Posted 8/26/2010 8:39 PM (GMT 0)
Suebear makes a good suggestion. I use wound vac's commonly for many of my patients. This can lessen the time it takes a wound to heal dramatically. A wound healing from the inside out can take quite a while. The packing of the wound is a very standardized practice for facilitating this type of wound healing. The offer of your surgeon to likely excise the wound and then close the remaining edges primarily would certainly be an option. If the pain is gone, this is a very good sign. This is a sign that the infection is likely well controlled and you are entering the home stretch.
Posted 8/28/2010 12:55 AM (GMT 0)
Hi college grad, I actually have a pelvic abscess wound that was opened on june 1, and is STILL healing! It started at 6x8 cm, has narrowed a lot. Two weeks ago it was still 5cm long, and I was freaking out. My dr. and wound nurse say all wounds are different, and as long as it is clean and making progress not to worry. We stopped packing with iodoform last week, because my nurse thought it might be too irritating, so now we just flush with saline. This week we measured it at 2.9 and very narrow! Yay!

Stick with it, it will heal. It's so psychologically and physically strange to have an open wound. Hope it closes soon...
Posted 9/9/2010 4:30 PM (GMT 0)
Update: I went to a different hospital, different wound doc, and he packed my wound with something called Oasis (new technology that heals faster and becomes part of the wound). Since that day about 2 weeks ago, I've had no drainage and my wound has closed up almost completely! Great progress!

Thanks for all the support guys...you were right--sometimes, these things just take a long time.

CollegeGrad85
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