Why Aren't Open Wounds Re-stitched? (Breast Surgery)

Question

I have an open wound post-op from my breast lift. My doc says let it be; reading stories here, it seems many other ladies are told the same thing. Why isn't stitching it closed done? It heals fine without it? It won't work so many days after the initial surgery? Of course I trust my doctor but I'm still curious.

Rady Rahban, MD, FACS · Answer

Excellent question. There are a number of reasons why it is not ideal to close an open wound. It often depends on why the wound opened in the first place. Many times there is an infection present or chronic contamination with bacteria. If the wound is infected and inflamed and closed, the wound will likely open again and be worse. You are essentially trapping bacteria under the skin. Another common reason for an open wound is excess tension and trying to close this would certainly lead to a similar and often worseresult. The body repairs the open edges by creating scar tissue and unfortunately this is usually thick and may need to be revised later. I hope this has helped.

Sheila S. Nazarian, MD · Answer

If you re-stitch open wounds, it may cause infection.  If a wound needs to be sewn, it has to be cut out under sterile conditions and re-sewn.  For superficial wounds, this is not done.  For deep wounds, sometimes this is the way to go.

Tom J. Pousti, MD · Answer

Thank you for the question.

	 Depending on the specific situation/wound,  closure of the wound may not be advisable because closure will likely not be successful ( For example within surrounding skin or tension in the area) and/or closure could potentially lead to an infectious complication ( formation of abscess).  An exception to this “rule” may be a wound that is unstable ( for example expanding and/or close to an underlying breast implant). 

	 The vast majority of wounds that occur after breast lifting or reduction surgery go on to heal (by secondary intention) without long-term sequelae.

	 Of course, your plastic surgeon will be able to provide you with answers more precise and relevant to your own situation.

	 Hope this helps.

Richard Bloom, MBBS (Hons), FRACS · Answer

Hi,

	Its a good question to ask.

	The two reasons I would give for not closing the wound are as follows. Firstly, once the wound has opened up it will be contaminated with any bugs that live on your skin, which should not be confused with infection. We all have them and it is normal. If however you close the wound there is the potential for those bugs to be sealed under the skin and to develop into an infection. The second reason is that wounds that heal on their own often are as good as when they heal when they are sutured.

	So in short, there is no big advantage and there is the potential to cause an infection.

	Reality is if the scar ends up being less than ideal, it is very easy to revise it down the track.

	 

	Hope that explains it.

	Richard Bloom

Anureet K. Bajaj, MD, FACS · Answer

One of the reasons that open wounds are allowed to heal from the inside out is that there was a reason why that wound opened.  A wound may open because of an infection, fluid collection, or tension on the wound.  If you try to close a wound under these circumstances, it will open again.  Under these circumstances, the best options is to allow the wound to heal from the inside out.  Once enough healing has occurred and the inflammatory process has calmed down, some wounds may be able to be closed secondarily.  Definitely keep in touch with your plastic surgeon during this process!  Good luck!

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Answers (6)

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