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Problems After Healing

You made it all the way to the finish line and got your surgical wound closed up! But then it starts acting up. This page is an overview of minor things that might go or feel a little off once you've closed the wound. It is rare for a healed wound to completely re-open and break down, but it can happen and this would be a reason to get in to see your doctor without delay. Or a Wound Care Center might be an even better choice.

Common Post-Healing Issues:

  • Splitting - can be a common problem, especially for those with very large wounds. Newly healed skin is very fragile and during your healing phase you probably were very careful about how you sat and moved. Once the major healing is complete you will start being naturally less careful and the strain on the new tissue will cause it to pull apart, usually right in the crack. One way to help minimize this is stretching as you get into the later stages of healing.
    1. Yoga - just be gentle. Leg lifts and knee bends are also something to try, the idea is to move your legs away from your body and bend them to stretch the muscles of the gluteus maximus. The skin in the cleft has to be able to stretch as the body moves and damaged skin only regains 70% to 90% of its original tensile strength (how much it can be stretched without tearing) so the wound area will never be as strong as it was prior to surgery, you have to "train" it back into stretching in the same way you do a muscle. Eventually, the skin will stretch enough so that it doesn't split.
    2. Moisture - the natal cleft becomes a natural airlocked area, this traps both moisture and bacteria, both of which can damage the skin. Try a medicated powder like Gold Bond twice daily to help keep the area dry.
    3. One product that has gotten good reviews for healing split scars: Aquaphor Healing Ointment.
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  • Pulling - is the sensation of tugging deep in the wound bed. This is perfectly normal and caused by the new tissue in your healed wound, which does not yet have the ability to stretch very far. Now that the wound is fully healed you are in the "remodeling phase", which can last from 6 to 18 months. All during this time new collagen fibers are being laid down and rearranged and the scar softens. Gentle stretching can help reduce the tension inside the wound.
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  • Itching and Tenderness - this is also normal. The newly healed scar is very tender and will be for many months. This is the peak period for "Pilonidal Paranoia" where every little tug, split or soreness will send you into a tizzy of being certain that "it's back". Don't drive yourself crazy, because it is very easy to do!
  • Itching - you might putting some hydrocortisone cream on the scar to alleviate the itching. It also might be possible that moisture build up has provided a happy home for Candida (yeast infection) which is easy to treat with over the counter mediations available at most drug stores.
  • Tenderness - this is something that I have always taken as a warning sign that your body is not happy about something you are doing. It may be the way you are sitting, clothing you are wearing (like thongs), too much activity that rubs the scar tissue.... What I always do at the first sign of tenderness is swab the scar with No Bump RX to take down the inflammation. Then I try and figure out what I am doing to make the area tender -- with me it's usually slouching in my chair while on the computer. See the You and your Scar page for additional tips.


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This page last updated: 11/10/2010

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