Incision on chest not healed completely.

[newarrior]

Amy sending you healing energy and prayers ! You got this ! ))))))))))) God bless you

 

[Amy]

So..... I’ve been using Aquaphor on my non-healing sternum (bottom-most part) and covering it with gauze. Now the scab’s not hiding anything, I think I see why it’s not healing :

There’s a clear, possibly plastic? fishing-line -looking wire sticking out, with what may be knots in the end of it. When I sit or lie down it moves down the entire length of the open wound!

Wtf?!?!?

Does anyone have experience with this? I’m going to send pictures to my surgeon, but up to this point CC has been amazingly unhelpful, so....

Any information about your experience with this kind of situation would be greatly appreciated. Thank you.

 

[Amy]

This must be a ‘spitting stitch’ - I found threads (..... : (. ....) about it from way back in the day - it seems this is pretty common but I never heard about it!

Has anyone here snipped off their own protruding (Polydioxanone? Vicryl?) suture??

If anyone has the same issue and wants to find old posts about it, here are some:

1. stitch coming out

2. protruding wires anyone?

3. did anyone else have spitting stitches?

4. String hanging!

5. I'm in stitches

6. Suture rejection?

7. Suture removal

8. Incision Site Has Discharge.. Help!

 

[MdaPA]

Has anyone here snipped off their own protruding (Polydioxanone? Vicryl?) suture??

It appears that this is the end of a dissolvable suture coming out of the bottom of the incision. It's either being pushed out as it heals or the surgeon didn't cut it flush enough with the skin when he sewed you up.

My wife had this after one of her OHS' and I think we just left it alone. It eventually fell off as it dissolved. If it bothers you, you can go have it clipped closer to the skin.

More concerning I think is that you still have a part of it still open with discharge. You should get it checked/cultured by your primary doctor or a Medic Clinic (again, this is not something your surgeon would be concerned with). My wife had a partial opening of her incision and she had to flush it with saline solution and pack-it (called "packing") with gauze twice a day until it closed up to avoid infection.

 

[pellicle]

More concerning I think is that you still have a part of it still open with discharge

agreed

 

[Chuck C]

So..... I’ve been using Aquaphor on my non-healing sternum (bottom-most part) and covering it with gauze. Now the scab’s not hiding anything, I think I see why it’s not healing :

View attachment 887847

There’s a clear, possibly plastic? fishing-line -looking wire sticking out, with what may be knots in the end of it. When I sit or lie down it moves down the entire length of the open wound! View attachment 887848

Wtf?!?!?

Does anyone have experience with this? I’m going to send pictures to my surgeon, but up to this point CC has been amazingly unhelpful, so....

Any information about your experience with this kind of situation would be greatly appreciated. Thank you.

Hi Amy.
Good news that you finally discovered the cause of the problem. I think the best thing is to get good medical advice on how to proceed. I know that your surgical team at Cleveland Clinic has pushed you to transfer to your local medical care previously, but this is so directly related to the surgery that I would hope that they would give you direction. If not them, hopefully someone local that can advise you on how best to treat.
MdaPA has suggested he believes it is a dissolvable suture. That would probably be a good thing, as the hope would be that it would soon dissolve away. However, your surgical team should be able to confirm if this is, in fact, what it is and what exactly to do about it. If they continue to shun you then please share that with the forum because this would be irresponsible behavior on their part that others need to be aware of before considering treatment at CC. It is one thing to have some of the best surgeons, but in my view, reasonable follow up with issues like yours is also something that any reasonably competent clinic should practice.
I really hope that you are able to get it resolved soon. It looks as though you are keeping the wound clean.

 

[MdaPA]

MdaPA has suggested he believes it is a dissolvable suture.

Amy, to emphasize what Chuck C said, I'm not a doctor so please don't take my word for it. Have it examined by a physician or nurse.

 

[Amy]

Well, CC has not deigned to tell me what it is, and only say I should have a thoracic surgeon look at it. Normally thoracic surgeons book months out here but I got an appointment with one in eight days. Still - eight more days of being unsure what to do, hoping it’s not infected.... Ugh.

 

[Unicusp]

Well, CC has not deigned to tell me what it is, and only say I should have a thoracic surgeon look at it. Normally thoracic surgeons book months out here but I got an appointment with one in eight days. Still - eight more days of being unsure what to do, hoping it’s not infected.... Ugh.

That's disappointing on the part of CC follow-up and care for the patient. Not surprised though. Personally, I would not wait another 8 days. If your regular PCP won't take you in today for a quick 5 minute appointment, I would go to a Urgent Care type facility. I would think that any competent physician or PA can identify the suture and confirm if you have an infection by visual or taking a culture. That's my opinion. Good luck!

 

[Amy]

Thank you, guys.

I went in to a different cardiothoracic surgery clinic’s office today and got a sterile suture removal kit. I’m gonna do it myself.

 

[pellicle]

Thank you, guys.

I went in to a different cardiothoracic surgery clinic’s office today and got a sterile suture removal kit. I’m gonna do it myself.

best of luck

 

[Unicusp]

Hello Amy. Since you are a DIY'er, and after you remove the suture, you may need some of this to close that open wound. Ha!

 

[Amy]

Ha ha. Are you joking or serious? While I *might* be okay putting super glue on my hand or knee, somehow I hesitate when it’s my sternotomy incision... There’s only about *a millimeter* : ) of open wound now, anyway, two days after I snipped the stitch.

Sexy/gory details for future DIYers: my husband’s role was to be behind me with his hands firmly on my... chest... which made the stitch stick out and be easier to get under; then I just held the knot with the (sterile suture removal kit’s) tweezers and snipped it; but then I thought it wasn’t close enough to the skin, and might be uncomfortable poking out, so I held the (fishing line-like-) thread still in there with the tweezers and was gonna snip it again; but I tried pulling on it just a bit first... and a bit more... and it came out! Like a little jimmy.

I guess the other end had already started absorbing. So I *might’ve* been able to just pull it out without even using the scissors.

So grateful and relieved! All this time, worrying it was infected, when all I had to do was cover it with Aquaphor-coated gauze for a day or two so a scab wouldn’t form, so I could actually see it was a stitch and snip it.

Thank you guys for listening to my concerns - I’d been trying to get this bottommost part of the incision to heal for five long weeks - from post-op week 4 to week 9. Thank goodness for this forum, as reading of other people’s experiences with stitches coming out gave me the confidence that I could take care of it myself, despite CC insisting I needed a thoracic surgeon to do it. Ha!

 

[Chuck C]

I tried pulling on it just a bit first... and a bit more... and it came out! Like a little jimmy.

Great news! You should be well on your way to full incision closure soon!

Never heard of a DIY suture removal kit until you shared with us that they the doc's office sent you home with one. What next? Perhaps DIY OHS kit!

 

[Amy]

So... as things have tended to go ever since the surgery, there were a few days of relative calm and inactivity, followed now by yet another unsettling question: what is this blister-type bubble that’s appeared on my incision??

 

[Chuck C]

So... as things have tended to go ever since the surgery, there were a few days of relative calm and inactivity, followed now by yet another unsettling question: what is this blister-type bubble that’s appeared on my incision??View attachment 887873

Does it seem fluid filled like a blister?

My guess is that you're going to have a little palpable scar tissue on that spot in that it took so long to close up. If it is fluid filled that may be something different.

My surgeon does all of his own closing of the sternum, bone and tissue, using glue for the soft tissue, and takes pride in how they generally heal without much scarring.

However, this was not the case for my drainage holes. I had a small one and a large one. The small one healed up with no scaring. The big one required a stitch and was removed and stitched by a surgical assistant, who did both removal and stitching very quickly. It has healed with a palpable scar- a little bump. No big deal at all, but I found it interesting that such care was taken to minimize scaring on the sternal incision and no such thought or care seemed to be given to closing up the drainage holes in a way that would not leave a scar. But, hey, I need some proof that I actually had the surgery, so it's all good.

 

[Amy]

Does it seem fluid filled like a blister?

Yep.

Sigh.

 

[Amy]

Well, the blister got bumped and oozed out.. then, when I thought it was finally going to heal (the next day) another blister started forming, (two days later) got bigger with exercise (or heat; or time) and then started oozing out the side. This is annoying, to be sure, but if it’s part of the normal healing process and is nothing to be concerned about, I would sure like to know. Has this happened to any of you? Should I stop the brisk walking, which increases the oozing? I’m 12 weeks post-op. I’m so tired of worrying about my incision. I don’t even know how pellicle dealt with the emotional side of his ordeal. Distraction? Meditation? Sleep? Alcohol?

 

[Unicusp]

Well, the blister got bumped and oozed out.. then, when I thought it was finally going to heal (the next day) another blister started forming, (two days later) got bigger with exercise (or heat; or time) and then started oozing out the side. This is annoying, to be sure, but if it’s part of the normal healing process and is nothing to be concerned about, I would sure like to know. Has this happened to any of you? Should I stop the brisk walking, which increases the oozing? I’m 12 weeks post-op. I’m so tired of worrying about my incision. I don’t even know how pellicle dealt with the emotional side of his ordeal. Distraction? Meditation? Sleep? Alcohol?

Hello Amy. Sorry to hear. Definitely not normal. Should have healed many weeks ago. Unless you want that large scar at the bottom, I suggest that you consult with a plastic surgeon. My opinion is it (the skin) needs to be reopened, middle removed, and edges sealed together to allow for a nice tight thin line. Eventually will disappear.
Probably super quick, outpatient, and easy for a competent surgeon.
Again, just my opinion. Of course this assumes no infection which needs verification. Hang in there. Could always be worse!

 

[Amy]

Probably super quick, outpatient, and easy for a competent surgeon.

I have yet to come across such a person in Arkansas, but how great if that were the case and such a one could be found! Everyone I’ve seen so far wants to stick their dirty fingers in it (till I pull away at the last second and say ‘don’t touch it!’) so I’m v-e-r-y hesitant to go to yet another ‘professional’... and apparently the wound specialists won’t even see you unless you’ve already done a course of antibiotics under the care of another doctor and been referred when it didn’t work.

A plastic surgeon? Would they know how to make it heal though? I don’t really even care about the scar at this point. Just wish it’d heal.