Stitch Glitch Part 2 - When to Call the Doctor & Wound Care

Packing strip for wounds.

"If it starts getting red and expanding out, call me," my doctor said before I left his office on April 15.
A few days later, I had a red rectangle forming to the left of my stitch abscess. The wound (nicknamed "Primordial Ooze") was responding well to treatment and looking much better, but what was causing the redness? My skin is pretty sensitive, and I chalked it up to irritation from pulling off the tape when dressing the wound.  I had another appointment scheduled on April 29, so I thought I would just keep an eye on it.

By the following Tuesday (April 22), it wasn't better. In fact, it was a little larger. And redder. And some skin was peeling, and there was a little lump that was sort of purplish and sore. I did not have a fever, but the area did feel warm to the touch. The clinic opened at 9am and I called and got an appointment for 11:15. If it was nothing, I was sure my doctor would tell me, and after all the work he put into this surgery, I was pretty certain it was better to have him look at it now than to wait until things got worse.

"It's a good thing you came in," he said.  He examined my red  incision area, thought for a minute, and then moved to the counter and started opening drawers."You're not going to like this," he continued.

"You want to open it up," I replied.

This time he used a local anesthetic (thank you!). Sure enough, there was some infection, and a couple more pieces of stitch to remove. Apparently my body likes to push out the stitches. Thankfully, at five weeks, they are almost all dissolved, so this shouldn't be an ongoing problem. My doctor gave me a prescription for an oral antibiotic to clear up the infection.. He assures me everything will heal fine and these abscesses won't affect the appearance of my scar. I just need to be a little patient while everything heals. Patience is a thing cancer patients get to practice quite often, so I am not too concerned about it.

I went home to start wound care. Now instead of one stitch glitch, I have three! Primordial Ooze is mostly a superficial wound now. I have not named the other two, although Frick and Frack come to mind.

Gathering supplies for wound care...good scissors help!

Here is my daily wound care routine.

• Collect all of my supplies (gauze, iodized wound packing tape (Iodoform Packing Strip by Curad), Aquacel (similar to silver alginate), gauze, tape, scissors, and tweezers). It is easier if you have everything ready before you begin.
• Remove the dressing from yesterday and throw it away. Rub off as much sticky tape residue as I can from my stomach.
• My first wound, which is more healed, gets an application of Polysporin (Neosporin would work just fine also), then gets covered with a strip of Aquacel (or silver alginate).
• The new holes get a piece of iodized packing strip placed in them with the tweezers. Wounds heal from the inside out, so each day, a little less of the strip fits down into the hole. When the wounds are as healed as the other one, I will just use the Polysporin and Aquacel on them, too.
• Cover the whole thing with gauze and tape it in place. Done for another day!

Aquacel

I am keeping my appointment on the 29th, just to make sure everything is healing fine. 

When to call the doctor:

Fever

Redness, especially if it is increasing

Redness that is warm to the touch

Signs of infection like pus

If you have any other concern with a healing incision or wound.

May 27, 2014
Update:  At my appointment (May 13) , things were healing well. He trimmed tissue and probed around one wound one last time before sending me on my way. I went back two weeks later (May 13), and my doctor said "It is healed. Wait at least 8 weeks more" (before scheduling my last surgery). So, I am still healing, but back in the gym, walking, and trying to figure out what my new normal is. Life after cancer treatment is full of some odd ups and downs, and some unexpected emotions, but I am finding my way through it one step at a time.

More on my reconstructive journey:
Diep Decisions! Diep Flap Reconstruction
Diep Flap Surgery & Recovery - Week 1
Diep Flap Reconstruction Recovery - Week 2
Diep Flap Reconstruction Week 3 - Recovery Can Be Boring
Stitch Glitch! - Diep Flap Reconstruction Week 4