Is the white inside the wound an infection, and how long are wet to dry dressings needed? (Photo)

Question

what is the white substance in the wound and how long is a wet to dry dressing required if the wound is no longer deep?

Vishnu Rumalla, MD · Answer

Thanks for your inquiry. The white is a combination of fibrin, collagen, and cells that that are trying to close the wound.  I cannot tell for sure where this wound is, but it does seem to be healing.  Please continue to discuss with your plastic surgeon.

Sean Hill, MD · Answer

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery – Frisco, TX:
Thank you for sharing your photos &mdash; I know it can be concerning to see changes at your incision site during recovery.
⚠️ Is This an Infection?
While I can’t confirm a diagnosis without an in-person exam, here are a few important things to know: • A white or yellowish substance at the incision site can sometimes be fibrin or dead tissue, which is part of the body’s normal healing response, especially in areas under tension or where healing is slower. • However, if it’s thick, has a foul odor, is increasing in volume, or is associated with pain, redness, warmth, or swelling, those may be signs of early infection or delayed wound healing.

Michele A. Shermak, MD · Answer

Thank you for this question.
As wounds heal sometimes there are small (or big) areas that present wounds in the healing incision. Small focal spots are typically due to absorbable sutures attracting inflammation to absorb the suture, and this sometimes works through the skin. Yellow in the wound is either fatty tissue or fibrinous exudate on the healing tissue. It is most often not pus, which is what many are concerned about. The wound will lift off this tissue in the healing process or the surgeon will remove that tissue in postoperative visits, which is what I typically do. Various topical treatments are recommended including Vaseline, Aquaphor, Medihoney or antibiotic ointments.

Steven H. Wiener, MD · Answer

The white inside the wound is not an infection. It is a combination of protein, collagen, and fibrin, all products of healing. I recommend washing twice a day with mild soap and water, or shampoo.  Keping the wound moist will allow it to heal faster.  I recommend using products like therahoney or medihoney twice a day.  I believe amazon carries these products.

George Bitar, MD · Answer

Great question! The area looks quite shallow, so there's not much to pack. I would recommend keeping it moist (with antibiotic ointment) and covering it with a dry dressing (bandaid). The area should heal by itself. The yellow at the base looks like granulation tissue, which is normal healing tissue.

Robert M. Wald, Jr., MD · Answer

The white material in this wound is not an infection. Infection generally presents with a lot of redness and purulent discharge from the wound. When a wound heals, some dead tissue may present that should be debrided either by a knife or wet to dry dressings. These dressing changes will be used until the wound closes.

Ira H. Rex III, MD · Answer

From your photographs, this wound does not show any signs of infection. The white debris will be pushed out as the wound continues to heal. You are dressing seems appropriate, although it may be easier to apply in appointment and Band-Aid if your doctor agrees.

Larry Weinstein, MD · Answer

At this point with minimal signs of infection, I usually switch to a small amount of hydrogel, which can be placed on a large bandaid to go over the wound. Your surgeon is the best person to determine what is best. Wet to dry dressings are a reasonable approach. The white tissue is collagen formation, fibrin which is building a platform for the skin to grow on and finally heal your wound.

Bradley A. Hubbard, MD · Answer

Thanks for your question. It is very difficult to determine what part of your body this wound is on. That being said, it does not appear to be infected. Your body will secret many substances into the wound to encourage or promote healing. That is the material that you are seeing not infection. You should be seeing your PS regularly to make sure that is healing appropriately. Good luck!

Bruce B. Kadz, MD, FACS · Answer

The white substance (as long as not pus), is the result of whiter cells and body natural products that help bridge the gap in healing. The duration of wet to dry necessity is very variable and depends on the size and depth of the wound, blood supply, smoking history, or any underlying medical conditions. It's usually a few weeks.

Is the white inside the wound an infection, and how long are wet to dry dressings needed? (Photo)

Answers (14)

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