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Have hidradenitis suppuartiva. Started burning and tingling sensations inside the surgical site. Any thought?

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General Surgeon
Practicing since : 1983
Answered : 12 Questions
Hi Doctor,
I was diagnosed in April 2012 with Hidradenitis Suppuartiva of the right labia, mons pubis, and inguinal region. I had 4 prior surgeries on this area to drain a recurring abscess over the course of 18 months, with no diagnosis until I saw a new surgeon in April, who told me about HS. The diagnosis was also confirmed by pathology report. I had a wide and XXXXXXX excision of the area with wound vacuum assisted closure. I had a polymicrobial cultures from the area and had to have a PICC put in as well. I developed an infection of the wound about 5 weeks into wound vacuum therapy ad my surgeon advised taking the vacuum off and washing with soap and water 3 times a day and silver dressings were used to pack the wound. I also had an area of undermining about 3mm in one area, which was packed aggressively. The wound closed on its own about 3 weeks later but remains very painful. I am 6 months post op, and I have burning, warm, pinching, shooting, and tingling sensations inside the surgical site. There is a small area of mild redness that my surgeon says is "normal scar color for now". She says nothing looks infected, but I am nervous. I was told that nothing looked infected for 18 months, and an MRI showed that the HS was far beneath the skin. Is it possible to have infection that is still XXXXXXX below and not have signs of it show on the surface? Otherwise, why does it feel warm inside the site? Why are there these strange pains 6 months later? My surgeon keeps saying "it can take up to 2 years for this tissue to fully heal". What?! 2 years? Does this sound right? I would like an MRI to see if there is any infection, but nobody seems to want to order one. Any thoughts?
Posted Sun, 4 Nov 2012 in General Health
Answered by Dr. Arun Prasad 9 hours later
Thanks for writing in.
If you have any pus discharge or any painful redness of the skin, we need to suspect a infection. Otherwise I don’t think we should be suspecting anything here. The warmth and the strange pains can either be due to the nerves getting involved in the healing process. It can also be due to your anxiety. If the area has been excised, then you are better off waiting for some more time. MRI will show scarring and fibrous tissue that will confuse the picture.
In my opinion, it would be best to nature and let nature do the healing.
Let me know if you have any more questions
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