The white stuff/(skin?) is forming again do i remove it? How will the hole heal when I keep a gauze pad inside 24 hr's?

Question

I have a Hole where 2 incisions meet that has not healed 5 weeks post TT surgery. I went to doc. she removed a stitch and put a clean Q tip with peroxide in the hole, cut out some white substance she called dead skin, she placed a gauze inside, approx 1/4" deep, covered and said to repeat 2 times a day for 2 weeks. But when i do it seems to enlarge opening and reforms the white rubbery stuff she called dead skin. Normal? Common? would a butterfly stitch be better

Richard H. Tholen, MD, FACS · Answer

If you are repeating what your surgeon did (using peroxide), this is what is "bleaching" the tissues white. Peroxide may help kill bacteria, but it also inhibits healing, unless, of course, there is active infection in the wound. (Then, you need more than peroxide.)Stop the peroxide, wash the wound daily with soap and water, and apply a saline-moistened gauze to the wound and it will continue to heal normally. But if you have other issues with your wound, it behooves you to follow your surgeon's advice. But you asked, and this is the only "adjustment" I would suggest in your surgeon's approach. A "butterfly" tape is NOT appropriate here. Best wishes! Dr. Tholen

Christian Subbio, MD · Answer

Really, it is best to follow the advice of your surgeon, and if you have any questions to ask her.  Only she knows what type of surgery was performed, and how the wound looks, having examined.  Any of us consultants on here are simply making educated guesses which can never substitute for having examined you.That said, the "dead skin "is most likely dermis and subcutaneous fat, that, when exposed to air, forms a whitish layer.  This is almost like a moist white scab.  I can tell you, that in general, I recommend very gently packing wounds like this.  You should not be stuffing gauze into a wound which might force it open further.  The packing should be snug but not crammed in there.  And, butterfly stitches are usually not a good idea in this situation  as they tend to trap moisture which needs to drain.Your best resource right now is her surgeon and I would keep in close contact with her and follow her device.  Best of luck!Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

James McMahan, MD (retired) · Answer

Thank you for your question.  Your surgeon is giving you good advice.  All of the dead tissue needs to gradually come out with local care and dressing changes, Then, healthy tissue needs to grow in to replace it and close the wound.  It will heal and close despite the gauze being in there.  You cannot just stitch it closed as the remaining dead tissue and bacterial contamination will result in an infection. Follow your surgeons instructions.

The white stuff/(skin?) is forming again do i remove it? How will the hole heal when I keep a gauze pad inside 24 hr's?

Answers (3)

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