Very worried about a surgical incision that isn't healing properly

Maite 2 months ago

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I am at my wit's end. It may sound only a minor thing, but....One of my smaller incisions from my 1st April RAPN has still not healed properly. It's in a very awkward place, under a large fold of skin low down on my right side of abdomen. I was allergic to the surgical glue the surgical team put on, despite it stating clearly on my medical records that I am allergic to glue on island dressing plasters. The glues wouldn't drop off and were taken off three weeks later by a nurse, because they had set up a bad rash and itchiness at all the incision sites. With ten days of Trimovate cream - after unsuccessfully trying out Epiderm and other substances - all of them eventually cleared up except for this one at the bottom, which has remained itchy and sore throughout.

I have visited my GP surgery five times now, and am booked in for another visit next Thursday as nothing has worked....latest nurse (two days ago) said, let's try an iodine dressing. Keep it on for two days at a time and within a week or so it should have dried up the sore, which is a small open sore at one end of the incision. The rest oif the incision is skinning over but not completely healing, and is a bit tender. It's the small round sore at the end that I'm really worried about as nobody seems able to suggest the right thing that will heal it. I haven't dared put on Savlon, although my instinct says to do so.

The iodine dressing is secured with micropore, which I have used for decades with no issues. I now find that I have become allergic to that also since my surgery! so I can now only keep the fresh iodine dressings on daily and for the time I am walking around with clothes on, to protect the sore from being rubbed by my undies.

My surgeon at the 8-week which should have been a 6-week, Weds last week, said to leave it open to the air. I cannot do that as it would mean walking around all day literally bottomless. I can do that for maybe an hour or so at home per day, which helps relieve the itching, but obviously I have to go out...walk my dogs...go to work...so have to cover up again. I always wear loose baggy clothing anyway, but it still rubs.

So I have conflicting advice: leave it open to the air....try iodine dressings....try nothing except loose undies....

My surgeon last week said it was healing nicely (despite it being obviously red, and itchy, with this little sore at one end that keeps re-opening itself) and that it was safe to swim when I am on holiday in now less than 4 weeks. The nurse on Tuesday said she wouldn't advise me to swim. We are going to France for two weeks and I'm really worried that this wound won't be under control by then. The nurses keep telling me it could take weeks longer to heal but that it eventually will. The surgeon couldn't even give a time line on it as he sees it as healed and that if this is the only thing that is bothering me, it's of little consequence.

I am also devastated if I cannot swim as that is my only chance in the whole year to be able to use a pool where other swimmers don't come into it and splash about around me (I am not a confident swimmer but love the water).

I cannot even get a message to anyone on MyCare, as the Send A Message function hasn't been enabled in two years.

I am now 9 weeks in and no sign of any real improvement and in less than 4 weeks I will be away in France. I am struggling to get on with daily essential things as this wound is constantly both itching me and worrying me.

I keep asking to see a nurse who specialises in wound management but they keep giving me appointments to GPs or to general nurses.

It all seems to have stemmed from that surgical glue they put on me. The medics seeing me are now coming to the conclusion that the non-healing is due to allergy, but they cannot seem to suggest what to do about it. My hayfever cetirizine doesn't work on the itchiness so I have bought expensive Allevia, but so far after two once-a-day doses that still isn't working either.

I'm beginning to wish I had delayed the surgery until after my French holiday, but I honestly thought 13 weeks would be ample. It didn't take anywhere near this long after my previous laparoscopic hysterectomy, to heal completely. I usually have very healing skin, and this has thrown me for a loop.

Have you any suggestions?? would Savlon be safe to try? I'm now scared to put anything on it frankly, not even my over the counter elastoplast plasters which again I have used all my life. I'm scared to try E45 cream which I used successfully on my scars after my hysterectomy. I don't know if I'm best to keep the sore dry or keep it wet? as it's not scabbing over properly whichever I do. But it's simply not practical to do what the surgeon suggested, and go commando, which I can see might stand a chance of working if I could live like this for 24 hours a day for the next week.

Helen K- Macmillan 2 months ago

Hi Maite.

Thanks for getting in touch through our online community. I’m Helen and I’m one of the Macmillan cancer information nurse specialists on our support line. I see you’ve joined some our cancer forums; I hope you are finding it a supportive environment here.

I’m sorry to hear about your ongoing problems with wound healing. It’s understandable you are concerned. Please don’t think that this is a minor thing. I can see it’s having a big impact on your wellbeing, especially with your holiday coming up.

I’m afraid I have to agree with your nurse, that unless the wound is healed by the time you go on holiday, we would advise against swimming.

There are lots of reasons why a wound might not heal, one of which is infection. I’m concerned that you describe it as being red, itchy, tender and with an open sore, despite your surgeon feeling it is healing well, as these are all signs of a wound infection.

You mention you have been seen at your GP surgery several times. If they haven’t already taken a swab of the wound, it would be advisable to ask them to do so, as this is the only way to tell if there is an infection present.

It’s important to find out whether there is an infection present, as if infections are left untreated, they can become serious and turn into sepsis, which is a life-threatening condition. Please find the symptoms and what to do if you have them on the NHS website.

If there isn’t an infection present, then you would benefit from being assessed by the tissue viability nurses. You mention in your profile that you live in Devon. There are two teams that cover the county, one that covers those with a North, Mid or East Devon GP, and on that covers those with a west Devon GP.

As we don’t have access to your medical notes or history, we are unable to say whether Savlon or E45 cream might be suitable for you to use. However one of our Boots Macmillan Information Pharmacists may be able to help.

You can find your nearest store to see one in person, or you can book a telephone consultation via Boots website.

I hope you found this information helpful. Please don’t hesitate to get back in contact with us if you need further information or support.

Best wishes

Helen K

The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm or contact us by email or webchat.

Ref: HK / DS

Maite 2 months ago in reply to Helen K- Macmillan

Thank you, Helen!

I probably omitted to say that in all this wound saga, there was a swab taken. That was just over two weeks ago and there was no infection present at that time.

I had to go for a renal blood test today, and on the way back I called in at the local pharmacy that I trust - I think it's an independent but not sure....is called Lupton's. I explained to the lady at the counter, and she asked if I'd like the pharmacist nurse to have a look at it. So I explained the whole saga to her from start to finish, and she did have a look at it.

She has managed to answer all the questions I have been begging the GP surgery to ring me about, mainly, what if anything I can put on it to resolve the itching. From the angle she was at - bearing in mind that I have to contort myself to be able to see right down that low - she said it looked ok to her and did look like it was healing. I pointed out the little sore that comes and goes depending on how much I move around and the clothing rubs, and she said that as she saw the incision, she could advise me to apply E45 cream (I have the normal one, which worked fine two years ago on my slightly itchy hysterectomy incisions and subdued those very quickly) and to put Vaseline on top of that, as a barrier. The Savlon: she said it is fine to apply that if I am worried that the little sore may not be healing properly. (I said, I hope that I am not now allergic to any of those!, having never been all my life, but am now almost scared to put anything at all on that incision as everything that touches it gives me a skin reaction.)

She didn't feel it was useful to go back to the Trimovate for another week, as there is no bacteria there and it wouldn't be particularly useful at this stage.

She still couldn't put a timeline on the full healing. I just keep getting told it "will heal eventually". She has reassured me to some extent because she could see it from a face-on angle and could tell that it is looking ok and is just very slow getting to look like the others.

She didn't feel it looked infected at this point in time.

I will be devastated if I cannot swim in four weeks. I have been reading up about waterproof plasters for surgical incisions specifically for swimming. A bit nearer the time, I will ask them at this pharmacy what they can recommend in that respect. Perhaps the incision will be looking even better by then, but I will still feel more secure if I apply a swimming dressing just for the times I am in the pool. My skin seems to cope with a dressing for a couple of hours before it starts to react, and I am never in the pool for longer than that at any time, so I would risk it. It's a very private pool, cleaned daily, so unlikely to have unknown bacteria from any human source although it does get bits of tree leaf and a few insects fall into it.

I will see how this "diet" of E45, Vaseline and a touch of Savlon goes over the weekend, and likely ring the GP yet again on Monday and ask them about this tissue viability nurse - I presume it is booked via the GP surgery?

Thank you for your help and advice, which in conjunction with the pharmacist having also answered some questions today, has made me feel a bit more relaxed and indeed at the moment, less itchy. Although I am trying to "go commando" indoors as much as possible so as to "let the air get to it" as the surgeon advised.

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Very worried about a surgical incision that isn't healing properly