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Healing after Sigmoid colectomy

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Healing after Sigmoid colectomy

Postby hppygr8ful » Sun Jul 08, 2012 12:46 pm

I just had an open sig on June 18. The pain has mostly resolved but I have a question about wounds healing. I have a tunneling wound that"s about 10 cm deep at my incision site and it just pours discharge. I am seeing a wound care nurse who says there is no infection but that this sometimes happens. So I go twice a week to have the wound cleaned, packed, measured etc......We are looking at 4 to 6 more weeks before this thing heals. I am on disability but I work in the medical field and am getting some pressure to return to work. My instincts say no and my doctor will keep me off as long as I like but I don't want to lose my job.

Bowel function is slowly returning to normal especially as I add fiber but I notice that I am having an every other day pattern where I get good solid normal movements followed by a day of almost none.

Anyone else experience this?

Hppy
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Re: Healing after Sigmoid colectomy

Postby Kathryn in MN » Sun Jul 08, 2012 3:16 pm

Go with your instincts and what your doctor says - do not let your work pressure you if you are not ready to return. One day at a time is the only way to get through the healing process.

When it comes to bowel habits after resection, everyone is so different. For me it was night and day - much BETTER after surgery. But that is because I had an almost fully obstructing tumor for a long time and had severe pain and trouble passing stool for 2 years. Once the tumor was removed, it was such a relief. And I was lucky and healed quickly (laproscopic surgery too), and had no problems with my bowels afterwards. I am mostly vegetarian with a very high fiber diet, and the fiber plus exercise really helps keep things moving. I did walk 3 miles or more every day starting with the week of my surgery. Are you getting mild exercise? NO lifting - but walking is good.

It is good the wound care nurse is on top of things and you are taking care of that. I hope you start feeling more "normal" soon.
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Re: Healing after Sigmoid colectomy

Postby tallyho » Sun Jul 08, 2012 3:56 pm

I didn't have anything quite like what you're describing, but my incision did "open" a little which allowed fluid to discharge - sometimes quite a lot of fluid if I recall correctly. My surgeon's office also was untroubled by this, and after a few weeks they treated the open spot with silver nitrate, which immediately closed it.
7/27/10 DX Stage I at age 30
9/3/10 sigmoid resection, 0/56 nodes +, no chemo
10/12 - CT - NED!
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Re: Healing after Sigmoid colectomy

Postby Guinevere » Mon Jul 09, 2012 10:02 am

I'm still healing from the proctocolectomy that was done almost a year ago. The outside healed too quickly and then I started chemo which impeded the inner healing and my body formed a drain (praise God!). Sometimes, we don't heal all over at the same rate, it seems. Take your time and heal. From my understanding of employment laws, they can't fire you because you're healing from surgery and aren't ready to come back to work. I may be wrong on that but that's my understanding.
God bless ~
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Re: Healing after Sigmoid colectomy

Postby hppygr8ful » Mon Jul 09, 2012 11:14 am

Thank you all for your replies,

I don't really think that my employer will fire me. He's pretty good guy infcat he's been paying me my full salary while I've been out, but iot's only a matter of time before he puts me on disability which will severely affect the family finances. My husband was out of work for over a year and our saving were negatively effected by that. We were just getting back on our feet when I got sick.

I am seeing the wound care nurse today - wish me tissue growth!

Suzanne.
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Re: Healing after Sigmoid colectomy

Postby Bev G » Mon Jul 09, 2012 12:53 pm

Hi Suzanne,

I hope (and very much doubt) that your recovery will not turn in to something like mine, but just a heads up, perhaps: I had a liver resection done in 4/10, and the incision went from one side of my rib cage to the other, then up my sternum, so maybe it was about 25-28" total. I had the same trouble initially that you are describing, but I don't think mine was ever more than about 3.5 cm deep (that's how far it was from my skin to my fascia). Stuff was draining out and eventually over the course of a couple of weeks they had to open the entire incision. Then I had a (nightmare) wound vac for quite a while (I can't remember how long now) and that thing drained about 600 cc of pus every day (but the infection, amazingly, was always localized...I was never given any antibiotics for it) There was tons of tunneling, and the tissue growth, despite the wound vac, was very slow. Eventually, about 2 months after the liver resection they took me back to the OR and re-opened the whole mess back to the fascia because there was so much tunneling going on just superior to the fascia. Once they did that, they acknowledged that it NEVER would have healed without doing so. At that point, I went to wet-to-dry dressings twice a day, every day, and the incision never fully healed until mid-October or early-November (ie 6-7 months). The scar is hideous (but who cares,I lived through it :wink: )

All this is just to point out that 10 cm is a LONG way to heal. While the wound vac didn't work for me, it might work for you, it reportedly work spectacularly for many people and perhaps you'd want to ask your wound nurse about it.

Why what happened to me almost certainly won't happen to you:

1) I have had type 1 diabetes for 48 years, and that has a big impact on would healing
2) I was incredibly ill at the time of my liver resection, very malnourished from months of nausea, and had very low serum protein levels (further impeding would healing)
3) My home care nurse really had no idea how to work with the wound vac, and didn't know enough to ask for help, nor did I know enough to realize she needed help. She actually created much of the tunneling by poking around under the new tissue.

At any rate, I hope you will heal very quickly. Try to keep your protein intake crazily high, as your body needs tons of protein while you are recovering from surgery, you also need a lot of spare calories. This is just my personal opinion (and not medical advice) but it seems to me like getting this repacked every couple of days might not be enough. The act of removing the old packing debrides the wound (ie removes old tissue that MUST come out to promote the growth of new tissue) and I wonder if you might heal more quickly if the packing was exchanging/replaced more often? JMHO.

Best wishes as you continue to recover from your surgery.

Bev
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12/09 Stage IV 2/22 nodes + liver met, colon resec
3 tx FOLFIRI, liver resec 4/10
9/10 6 mos off chemo, Neg PET&CTC CEA nl
2/11 finished total 10 rounds chemo

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