Submitted by soapboxingdaychamp t3_1227hqv in mildlyinteresting
WastingTimeIGuess t1_jdpo2pe wrote
Reply to comment by Bttm4FandT in Incision in my arm that doctors left open for 2 weeks after a surgery. by soapboxingdaychamp
No - why not stitch it up? We all get why they had to take care of the wound.
Bttm4FandT t1_jdpoans wrote
Because you can trap in bacteria and stuff before it has time to heal, you have to clean the wound and bandage daily.
Benbot2000 t1_jdq3s78 wrote
I would think that leaving it completely open would result in a much higher risk of infection.
bearhaas t1_jdqw3jx wrote
Understandable thought. In fact, we used to close all wounds on the battlefield during early wars. But eventually it became clear that closing the wound just traps in bacteria. Bacteria are just like us. They like warm wet places. So now standard of care is to leave infected wounds open and they heal from the bottom up. Best thing for a wound is to be draining and not accumulate.
Source: I’m a friendly surgeon
StupidSexyFlagella t1_jdrzdh7 wrote
Friendly surgeon or friendly *for a surgeon*?
bearhaas t1_jdsg1i7 wrote
I like the former but probably the latter
FantasmaNaranja t1_jdsf4qn wrote
having lived near the equator im not so sure humans really like warm wet places
theluckyfrog t1_jdr4lca wrote
All wounds have bacteria in them, but unless you've got certain comorbidities, your body is really good at using its own mechanisms to handle that, as long as all the waste products (dead white blood cells, dead tissue cells, loose bacterial cells) have someplace to go. When a wound is "open" like this, they get sloughed off the surface and absorbed by the bandages. No big deal (from your body's perspective). But if the wound is closed, all that stuff just collects in it, and you get an abscess which prevents further healing, causes pain and inflammation, and can lead to sepsis if the bacteria gets into adjacent blood vessels. It's like the difference between taking your trash out on a regular basis or keeping all of that trash in your kitchen as it rots.
anewconvert t1_jdrq72b wrote
Bacteria aren’t smart. They don’t think “let’s go over there to eat”. They go from high pressure to low pressure (lots of bacteria to fewer bacteria).
Basically If you leave the wound open the bacteria can’t burrow into healthy tissue. They are met by a host of immune cells and connective tissue that makes the process hard. If you close the wound you trap the bacteria in a warm, wet space with plenty of food. They will multiply and pressure will build up and start separating the tissues and the bacteria will move into that new area. That’s an infection. If they have somewhere else to go that is no longer an infection. Leave the wound open and it will heal towards to skin, then the skin will heal over the healthy tissue and there will be no pocket for bacteria to hide in. This is a VERY simplistic way of describing the process.
squishymelon t1_jdqnnhd wrote
You remove the gauze 1-2 times a day and when you pull it out it takes a lot of the gunk out with it which helps to clean the wound
WatermelonWithAFlute t1_jdpugoj wrote
is there any reason why you can't just clean it and then immediately stitch it?
Bttm4FandT t1_jdpvlv9 wrote
I think from what i remember, stitching it up is a lot like intubating someone. High risk of infection. Also for draining purposes.
los-gokillas t1_jdqsy2c wrote
We've been so programmed by movies and TV to think that every single wound needs stitching. Often stitching is not the best option because it has a higher chance of infection. Being able to observe an open wound and clean it multiple times a day is healthier. Though it does create more of a scar and a aesthetically people don't love that
WatermelonWithAFlute t1_jdr57qm wrote
Why does it have a higher chance of infection if it’s immediately cleaned beforehand, though?
los-gokillas t1_jdr5hi7 wrote
Anything that was missed is stuck in there and it will take longer to notice an infection starting. An open wound can be continuously cleaned which allows for error and you'll be able to see the skin and fluids changing colors or even start to notice a smell earlier
WatermelonWithAFlute t1_jdr6cbx wrote
That does make sense, though wouldn’t the constant exposure be an issue? Cant clean it if your sleeping. Although I guess you’d probably have it wrapped in something- I can’t imagine you’d just have your arm like that exposed the entire time. I’d hope.
los-gokillas t1_jdr6h0k wrote
Sure no, but you could clean it right before bed and after waking. Couple that with a midday clean and you're probably on a fine schedule
Bttm4FandT t1_jdpvpm9 wrote
Some people require wound vacs to keep the fluids out of the wound so I would guess that can play a huge part in it.
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