All of Karen's stitches have torn themselves out. The stitches themselves didn't break; you can still see the loops on one side of the wound, but the other half have been slowly tearing right through the skin. You can see the path they took on the way through to the other side. I thought about including a picture, but figured it might be too much. Some have big ugly paths that widen as if they went quickly taking more skin with it. And others have small narrow straight lines for paths, as if they slowly worked through. All but one stitch is left. Karen called yesterday to tell the surgeon the wound had opened back up again, and to see if he wanted to put more stitches in. But when he returned her call he said when he had seen the wound last week, he knew he couldn't put anymore stitches in. Same with staples, the skin just wouldn't hold them.
Karen felt we should just cut the little loops and pull the stitches out ourselves. I was a bit hesitant, but agreed to help. I was mostly worried someone would give us grief about doing it ourselves, so I took some pictures first as proof they weren't holding on to anything. They were just loops on one side of the wound, dangling there. It went well, but after a day of thinking about it, and after seeing the wound so close up, I didn't feel as if the doctor had realized how much the wound had changed. It's a horizontal cut, but the distance of the vertical opening was probably an inch across. The only time I had seen it this wide before was in the hospital when Karen was swollen up like a balloon. The mesh was also folding up on itself; it reminded me of brain tissue. I called this morning and they agreed to see us. The surgeon took a look at the wound and said it was almost as if the body was trying to force the mesh out. Then he brought up his phone and said, "Would you be available for surgery... this Thursday?"
He said it's a full day of surgeries, so he would have to fit us in later in the evening, but we needed to do something. Of course we said we were free and willing. He said he would have to remove a lot of skin, and it would be an even tighter stitch. He paused, thinking, and said if we couldn't come up with something, then we'll have to do the surgery as soon as possible. He had a brief discussion with another doctor and he stumbled upon the idea of using a Wound VAC to help heal the wound. VAC stands for Vacuum Assisted Closure, which sounds a bit rough, but actually provides quite a few benefits. One of which is drawing blood flow to the area for faster healing. It typically takes two to three days for the insurance company to OK such a device, so he brought in a wound nurse and we came up with a temporary solution.
We're now using an ostomy bag around the wound until we get the prior authorization from the insurance company for the VAC. This will hold the wound together preventing it from opening more, and it also catches all the drainage Karen's been having. And there's been so much drainage. With an open wound the JP drain isn't able to hold suction. We've been changing the bandage every four or five hours when awake, and it's completely saturated. Since the catheter wasn't helping much, and now with the temporary solution and upcoming Wound VAC, they could remove the catheter. This made Karen happy. Every little tug or bump on the thing hurts. It's literally just a tube they poked in through the skin and pushed over to an area near the wound. The surgeon says if the VAC is working, he may even push the surgery back a bit further to allow the skin more time to heal.
