Identifying large or open wounds

Large wounds will usually require suturing to close. The type of closure will depend on the severity and location of the wound.

If the edges of the wound are irregular, infected or old, the surgeon will usually need to remove the tissue around the edges of the wound so that there are nice, straight, fresh edges that are likely to heal when held together by stiches.

This means that the wound sometimes ends up looking larger after the surgery than before it, but this is an important part of the surgery.

Wounds are most difficult in areas under a lot of tension, such as the limbs from the knee/elbow downwards. These areas don’t have a lot of spare skin to pull together once a part of the tissue has been lost, so this places the stitches and the skin under a lot of tension during the healing phase.

Surgeons will take extra care with these wounds, and the wounds will need to be monitored very closely for any sign of the wound breaking down or sutures pulling through the skin.

Conversely, a wound in an open area such as the abdomen or chest has a lot of spare skin. This can mean that the inflammation and fluid in the area can create a large volume of fluid to accumulate.

A surgeon will often choose to put a ‘drain’ in an area such as this, leaving an open whole with a piece of tube protruding from the sutured wound in order to allow fluid to escape the area so that it does not accumulate and cause discomfort, infection or wound complications.