incision splitting open

[tyggerss2]

I broke my R ankle in August and had 8" plates screwed in on both sides of the ankle to hold the bones together (they were vertical breaks.)  The skin is stretched so tight over the inside ankle bone and the bottom edge of the plate that the incision keeps breaking open.  I had a second surgery to clean it up and resew the incision.  It has broken open again, and the edge of the plate is visible.  One of my other doctors saw the wound and suggested wound care to try and close it up.  My doctor said it wasn't necessary and to just keep it dry and bandaged,  (I am not seeing hiim until the middle of January.)   He is leaning to more surgery to remove the plate, but I would rather try something less invasive.  Is there something feasible that could be tried before I have to result to major surgery?

[gail400]

I have an old incision from gallbladder and appendix removal.  About 3 months ago, the incision became inflamed right at my waist line. (The incision runs vertical on my right side about two inches from my belly button.)  From the rubbing of my clothing at my waist line, the incision became not only inflamed but opened up to about 1/2 inch and developed a hole about 1/2 deep.  The hole and surrounding area then started hurting severly and started to pus and bleed, sometimes profusely.  I have been seen by my doctor who prescribed me an ointment, that used three times a day, should have healed the incision in three days.  It's been about 12 days and the incision is no longer oosing pus or blood but is still sore and very red and is still painful to the touch.  What do you think the next course of action should be?  I don't see my doctor for another three days.  He advised me that the incision may have to be repaired.  Thank you in advance for your advise.

Gail Zink  

[tyggerss2]

Thank you for prompt reply.  There has never been any infection, only very tightly stretched skin.  The original incision was stapled.  When it pulled open, I had knee surgery and he also cleaned up the ankle incision and sutured it.  Eventually, the skin pulled the stitches apart.  My biggest worry is that the skin is shrinking and has now slid over the plate and the bottom edge is now under the plate.  My doctor said a skin graft would not work as it would not stick to the plate.  I am now just waiting for my doc to get back from vacation and I see him on 1/15.  

[Bhupinder Kaur, MD]

Hello,
The incision is splitting open but is there any symptoms and signs of infection like redness, warmth, pain or pus discharge? The main cause of gaping or opening of the stitch line or of the wound is infection. Severe cases of wound gaping may require dressings for a longer period of time or even a resurgery to stitch the incision line together. Surgery is opted only when infection has subsided and wound is a healthy wound with no pus and healthy pink granulation tissue is present in the wound.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.