Wound Healing Myths BUSTED - What I've Been Doing Wrong As a Surgeon

[@kellyshort700]

So refreshing to actually have a surgeon recognize how to properly heal a wound. As a wound care FNP I can tell you that there are many providers still recommending to patients they dry out the wounds or "allowing them air out" also using peroxide in wounds. Those are the two most common things I see patients being told to do prior to seeing me. I educate my patients on exactly what you are explaining, of course in terms they can better understand, but this is a great video. Acute surgically created wounds that are sutured, stapled, or glued heal differently that chronic wounds and dehisced wounds. Thank you sir for posting this video for more people to learn how to better heal their wounds.

[@citizensurgeon]

Thanks so much for the supportive comment! Agree, wounds should not “dry out” but everyone talks about it like they should!

[@Locsondoc854]

I'm Grateful for your easy teaching style

[@citizensurgeon]

Thanks so much!

[@julieg8000]

You’re my go to! I certainly appreciate your expertise- your presentation is extremely helpful when explaining healing techniques to my patients. Thank you for what you do! 🙏🏼

[@citizensurgeon]

Amazing! Love that so much! Thank you. If theee is a topic your want to learn about, for you or your patients, please let me know.

[@rosevieballesteros]

You’re an excellent teacher Dr. Pearson really love the way you explained and easy to comprehend god bless you always 👏👏👏👏👏

[@citizensurgeon]

You are welcome!!! What topic next?!

[@roos9032]

Why do wound got so water realize and past please help

[@GabrielSantAnaCarrijo]

You are a fantastic teacher

[@citizensurgeon]

Thanks so much!!

[@jamespeters6796]

Thank you!

[@mrcleanisin]

A cut/abrasion on the top of the finger joint that is flexing when you use your hands and submersed in water when washing your hands. Also, superglue/newskin to hold skin together.

[@tonywpiano]

What about DMSO? is that helpful?

[@tarunaramnath8714]

So then can you add hydrogel directly onto an Eschar? Or does it need to be debrided first?

[@citizensurgeon]

In many cases hydrogel can be applied to an eschar or scab, usually when there is no exudate and no infection. The hydrogel will hydrate the eschar and assist with healing.

[@kellyshort700]

It is recommended not to sharply debride stable eschar, unstable eschar can be debrided with a curette or scalpel. I prefer the curette. Topical enzymatic debridement is helpful to provide moisture and start the process from moving the eschar from stable to loose and unstable. I like medihoney gel. Santyl is an excellent product, but the cost is a hinderance for most patients. You can score stable eschar with a scalpel and that will speed up the process when using topicals.

[@berryc52]

Skin tears are very common amongst elderly. Any information on this often serious condition?

[@helen2430]

Hi I have same issue with mum these have helped......liposomal c....zinc.....vitamin a.....e .......etc

[@DaisyMbonge-m8h]

My wound is always fresh what could be the reason

[@ntkna3717]

Can you make a video about wound vac?

[@citizensurgeon]

Absolutely!

[@dianeibsen5994]

Thank you for the video. A few questions.. What if you're doing warm compresses and the scab comes off because of that? How can petroleum from a fossil fuel be good for a wound? Also, if someone has an infection they should think about other people when they're swimming in public places with infections! Ugh!!

[@citizensurgeon]

Thanks for the questions and I apologize for the delayed reply. First...petroleum for wounds...yes, sounds strange. Petroluem ointments like vaseline are highly refined, things like polcyclic aromatic hydrocarbons (PAHs) are removed, and it is processed so they are safe for effective wound care. The benefits of these are that it creates a protective barrier, promotes a moist healing environment, reduces friction and irritation, soothes and relieves discomfort, it is hypoallergenic and safe and finally it is cheap and widely available. To your second question, people with open wounds should not be in swimming pools! Yuck.

[@noraclark7677]

Not letting it breathe was the most surprising to me. I once had a foot injury with a very nasty messy wound. Part of it went over my ankle bone where there was not much flesh and they closed it with sutures as best they could and when they took them out that part of the wound was still not completely healed. I then had a cast on my foot and when they took that off it was still not fully healed. They put a dressing on and told me I could take it off and let the air get at it if I was sitting at home with my foot up. I did that and yes I got a scab and that scab was still there three months after the injury.

[@citizensurgeon]

Thanks for sharing Nora, sounds on the foot and ankle can be tough, for a lot of reasons. There are some really advanced dressings now and if we can provide a moist healing environment we can get more accelerated healing. Hope you’re all healed up now!

[@noraclark7677]

@@citizensurgeon Oh yes! This happened back in 1987 when I had a piano fall on my foot and it was a bad injury. It took a whole year but it was eventually perfect. It is wonderful that there such improved dressings etc now! etc. I know I had a very fine doctor. He is still working as vice president at our children’s hospital and is the quality and safety person there. Something I know you can relate to.

[@Susan-q4t]

Lloó😮😮😮iiio

[@valerie3955]

As I sit here with a wound on my face from cancer removal, I realize that I have been doing EVERYTHING wrong. LOL

[@citizensurgeon]

I'm sorry, apologies for the delayed reply! Good luck to you and I hope you have a speedy recovery.

[@83madziak]

Do you have any tips for wound healing after episiotomy?

[@citizensurgeon]

First I would talk to your ob/gyn, they certainly would be the expert for your wound. In general wound care principles still apply. Keep area clean, can use a perineal bottle to rinse area after urination and bowel movements to prevent trauma from scrubbing, use absorbent pads to control exudate, have good nutrition and appropriate follow up.

[@BoomVang]

Thanks for the plausible advice. Ironic that I just realized I have to violate the scab removal rule for a bad skin cancer case. If not removed daily, fluids etc push upwards and outwards until skin agonizingly ruptures and bleeds. This is for the long waiting period for proper surgery, when tylenol is my only friend.

[@citizensurgeon]

Yes, I’m sorry you’re experiencing that, Inhave two family members that went through something similar. Chronic wounds can be evidence of an underlying cancer, especially squamous cell carcinoma and basal cell carcinoma so it’s important to get any non healing wound evaluated. Good luck in your surgery!

[@ThomasCarpenter-r2f]

God bless you Dr.

[@citizensurgeon]

Thank you!

[@GabrielSantAnaCarrijo]

What is your opinion regarding retinol based topical creams for wounds?

[@Aldrene-n4s]

Thank you very much.

[@citizensurgeon]

You are welcome!

[@citizensurgeon]

Which of these myths were the most surprising for you?

[@daniellelopes9936]

Third myth. All my life I believed that scabs are sign of excellent wound healing! Thank you for support. Hugs from Brazil 🇧🇷

[@paulbrncik4263]

What about Iodine, is that bad for a wound?

[@citizensurgeon]

Iodine can be used to reduced bacterial load but shouldn’t be used chronically or in high concentrations as it will be cytotoxic to healing cells in the wound bed. Better to clean, gently debris and irrigate with water or saline and provide a moist healing environment with good exudate control.

[@ajohn67]

What do you think about Aquacell Extra?

[@ajohn67]

Sorry if I already asked this? What do you think of Aquacell Extra ?

[@ajohn67]

Any thoughts on Vashe?

[@abdulrahmang.i.mossaad2394]

how about the usage of hydrogen peroxide in infected wounds?

[@citizensurgeon]

I would say infected wounds need drainage, debridement and possibly antibiotics, definitely evaluated by a doctor

[@abdulrahmang.i.mossaad2394]

@@citizensurgeon Thank you for your rapid response. I understand that this is a big topic that’s up for discussion. I wanted to know if specifically in a patient with an infected wound in which drainage is done and antibiotics is prescribed, would hydrogen peroxide be a viable option to clean out the wound for the first few dressings?

[@islanddogkauai]

I have “t point wounds” opened after 3 weeks from breast lift. They are are now 1.5 cm x 1 cm wounds and have been draining and spitting stitches. They don’t show infection but drain a lot. My surgeon has me using calcium alginate dressings but each time I change it 2-3 iMessage per day. They are stuck to the wound and feel like peeling off a scar, even though it’s just the drainage crusted over the dressing. Do you have a different opinion for a better way to dress and manage the weeping fluid?

[@kellyshort700]

You should see if your surgeon is willing to send you to a local wound care clinic to assist with healing of the dehisced or "open" surgical wound. Alginates are designed to absorb large amounts of drainage. Alginates are not usually changed 2-3 times per day. There are better products to reduce pain, provide moisture to the wound bed, and allow for better healing. However, it is not advised to get advise from the internet as your wound will need to be assessed and evaluated by a wound care specialist so that the right treatment for you can be determined. Best of luck.

[@RabiaSammy]

Not sure to get scar excision or just wait for verteporfin with scar excision

[@citizensurgeon]

Definitely something to talk to your dermatologist about for sure!

[@ThomasCarpenter-r2f]

I hope the hydrogen peroxide has been cause my problems from cvi . They did not tell me it's bad to use .

[@citizensurgeon]

I think saline or water is safe for an irritant, as I discussed in the video I stay away from h2o2, especially full strength.

[@careborne]

Sterile environment with a lac?! How?

[@citizensurgeon]

I was referring to surgical incisions that go deeper than dermis. If it’s a not surgical laceration then it can be sterilized and closed with sutures, staples or steristrips.