Actually the title of this post, and future ones, should probably be “My Open Wound #XX.” As you might gather, I still have an open wound.
Our story so far involves a bit of infection, treatment for that, and a lot of wet-to-dry dressings. My incision up to this point sort of looked like this —O-o—. The ‘o’s represent areas that hadn’t closed. There was on larger area and one smaller one below it. When I got home yesterday I had only one open area, unfortunately it wasn’t that one of the two had gone away, instead they had joined.
Bah! That’s all I could say. Bah!
Okay, I did in fact say a bit more than that, I called my surgeon’s office and said I’d noticed some changes in the wound that concerned me. They scheduled me this morning and took a look and the fun began.
First of all they said nothing about my would looked really bad. It is showing signs of healing, even if it had opened up a bit more. It is shallower they said which is good. I agree there. They also took a sample and are sending it out for culture to see if I still have any infections going on, though it ‘looks clean’ according to everyone who peeked in.
After debriding the wound a bit more they decided that instead of more wet-to-dry dressings (which according to my research are not state of the art these days) they were going to prescribe Collagenase Santyl, a “sterile enzymatic debriding ointment.” Basically this is an enzyme, or so I’m told, that will eat up any necrotic tissue.
Basically it seems the two area joined because there wasn’t much holding them together as far as live flesh goes. As the bit between the two areas wasn’t getting much blood it really wasn’t live healthy tissue or even live fat. So apart it came and voila, a bigger wound, though in fact the wee bit of healing was really only concealing an opening between them underneath.
Some other things were discussed including a negative-pressure dressing, taking me back to surgery and cleaning things up and putting me back together, or sending me to a plastic surgeon for a look.
They decided that having a plastic surgeon take a look was the best option.
So off to another office I went. I didn’t have long to wait, apparently he had an opening and in I went. A genial younger fellow (as in younger than me, not a teenager), he took a look at my wound and said it looked pretty good. He showed me the difference between good tissue and necrotic tissue and fat and said he felt he should ‘neaten things up a bit.’ That meant he went in with surgical scissors and such and snipped and trimmed things up.
He did this in his office with an assistant and blood splatters were kept to a minimum. Actually I’m pretty sure there weren’t any. As the nerves along the incision were cut and haven’t healed, I really didn’t feel anything, though I could hear the snip, snip, snip of his scissors.
Then he said that the Santyl was a pretty good idea for no more than a week and said I should come back then for him to take another look. He also suggested that if I wanted, after things healed up, he could have me back and make the scar much smaller. I thanked him but frankly, I don’t really care. Let’s just say that any bathing suit I would care to wear will conceal this scar.
So where does this leave me?
It’s going to be a while, perhaps a month, before this closes up completely but things look good. This does of course keep me from swimming. I did ask about exercise and the plastic surgeon said to have at it. It’s unlikely to do any damage as long as keep things clean and dressed.
I don’t know if there’s anything growing down there that shouldn’t be at this point. The culture will take a bit of time, last time it was over twenty-four hours, but not much more than that. No one is saying it looks infected though.
I have to go back in a week to have the wound checked by all concerned (well not me really, I am concerned but so far my medical expertise is pretty limited). That will be my six week mark and will include x-rays of the hip itself.
All in all things are good. I’m not happy about the way the wound is healing but there’s not really much I can do besides keep on keeping on. Frustrating? You bet. Dangerous? Not so much as long as I’m diligent about caring for it. Yeah, it’s humbug. Not only that, it’s expensive. My Co-pay on the ointment was $75. Ouch. I should have put a whole lot more pretax money away for this year but who knew?