Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

121 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Hello Doctor...if you remember i was in touch with you

Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 16703 Questions

default
Posted on Mon, 28 Jan 2019 in General Health
Question: Hello Doctor...if you remember i was in touch with you about my sinus tract skin condition in my left groin. i wanted to provide you with an update about my condition. i saw a general surgeon consultant a month ago and he conducted the surgery on me. he made excision of the skin with primary closure...he mentioned that he removed all sinus tracts and damaged tissue...after two weeks when he removed the stitches and it looked inflamed and then slowly started to heal because i was applying betadine cream everyday...after another two weeks i had to travel and when i reached my destination i can tell that my problem would come back because the skin was inflamed and i can see some skin areas about to pop because of blood being trapped...and it did unfortunately...even some days ago some of the wound opened with pus coming out....it feels like my problem was never really fixed and more areas now around seem fragile...please find attached picture right after stitches removed and another after my trip..in summary i notice my problem always gets worse when i run in the gym or fly on a airplane maybe due to pressure or increase of blood flow which needs to exit my skin due to bad tunnels under it...im supposed to see him again in two days but want to get your opinion on what you think is wrong....he is somehow confident that this is Hidradenitis Suppurativa but does it usually happen like that? i attached also the lab report of the removed skin tissue. thank you
default
Follow up: Dr. T Chandrakant 0 minute later
Hello Doctor...if you remember i was in touch with you about my sinus tract skin condition in my left groin. i wanted to provide you with an update about my condition. i saw a general surgeon consultant a month ago and he conducted the surgery on me. he made excision of the skin with primary closure...he mentioned that he removed all sinus tracts and damaged tissue...after two weeks when he removed the stitches and it looked inflamed and then slowly started to heal because i was applying betadine cream everyday...after another two weeks i had to travel and when i reached my destination i can tell that my problem would come back because the skin was inflamed and i can see some skin areas about to pop because of blood being trapped...and it did unfortunately...even some days ago some of the wound opened with pus coming out....it feels like my problem was never really fixed and more areas now around seem fragile...please find attached picture right after stitches removed and another after my trip..in summary i notice my problem always gets worse when i run in the gym or fly on a airplane maybe due to pressure or increase of blood flow which needs to exit my skin due to bad tunnels under it...im supposed to see him again in two days but want to get your opinion on what you think is wrong....he is somehow confident that this is Hidradenitis Suppurativa but does it usually happen like that? i attached also the lab report of the removed skin tissue. thank you
default
Follow up: Dr. T Chandrakant 7 minutes later
pic: 0000 : after stitches removed
pic: 0000 : after my plane landed in a day
pic: 0000 : yesterday
default
Follow up: Dr. T Chandrakant 0 minute later
pic: 0000 : after stitches removed
pic: 0000 : after my plane landed in a day
pic: 0000 : yesterday
default
Follow up: Dr. T Chandrakant 4 minutes later
i forgot to mention that i did take antibiotics right after surgery and always applied betadine ointment every night...he did mention abt applying blue diode why removing the damaged sinus but doctors do not get technical sometimes when talking...so i cannot know for sure what he exactly did...thought he seemed to know about this problem...im just really scared now because it feels like my scarring increased to more areas.
default
Follow up: Dr. T Chandrakant 0 minute later
i forgot to mention that i did take antibiotics right after surgery and always applied betadine ointment every night...he did mention abt applying blue diode why removing the damaged sinus but doctors do not get technical sometimes when talking...so i cannot know for sure what he exactly did...thought he seemed to know about this problem...im just really scared now because it feels like my scarring increased to more areas.
doctor
Answered by Dr. T Chandrakant 56 minutes later
Brief Answer:
Looks like seroma caused the recurrence. Apply pressure dressings.

Detailed Answer:
Hi.
Surely, yes.
Thanks for your review query.
Noted the detailed history and serial photos with the report.
I can understand your concerns.
This looks like Hidradenitis suppurativa as is supported by histopath report.
The first photo shows satisfactory healing.
Further photos show a likely recurrence with similar tract.
The most probable causes are:
Failure of inner healing probably due to shearing that occurs while running, walking and sitting. Shearing causes the seroma like condition wherein the serum/blood collects in the just healing tissues. And with the increasing pressure within the fluid comes out of weak part of the skin.
I know that it may not be possible for you to have full rest, doing minimum of activities for proper healing to occur; but if possible avoid running and such activities that creates shearing at the affected area.
It seems that your surgeon applied blue diode laser as a mechanism to scrape the affected area, kill the granulation tissues for proper internal healing.
The last photo shows apparent sinus tract formation which may be a smaller than before.

I would advise you the following in such a situation:
Avoid hot and humid atmosphere as this causes more sweating adding to the problem.
Use loose clothes and allow proper aeration of the area.
Apply pressure bandage soaked in Liquid Liquid Betadine till you see your Surgeon.
If possible push in hydrogen peroxide to clean the wound and then pressure dressing with a sterile gauze soaked liquid Betadine.
Take multivitamins and mineral as these help in healing.
All these may help to obliterate the tract and hasten healing for skin getting attached to the under-surface and thus have healing.

I hope this answers your query and helps.
Please let me know the feedback once you the Surgeon.

Take care.
Wishing you complete recovery.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. T Chandrakant 0 minute later
Brief Answer:
Looks like seroma caused the recurrence. Apply pressure dressings.

Detailed Answer:
Hi.
Surely, yes.
Thanks for your review query.
Noted the detailed history and serial photos with the report.
I can understand your concerns.
This looks like Hidradenitis suppurativa as is supported by histopath report.
The first photo shows satisfactory healing.
Further photos show a likely recurrence with similar tract.
The most probable causes are:
Failure of inner healing probably due to shearing that occurs while running, walking and sitting. Shearing causes the seroma like condition wherein the serum/blood collects in the just healing tissues. And with the increasing pressure within the fluid comes out of weak part of the skin.
I know that it may not be possible for you to have full rest, doing minimum of activities for proper healing to occur; but if possible avoid running and such activities that creates shearing at the affected area.
It seems that your surgeon applied blue diode laser as a mechanism to scrape the affected area, kill the granulation tissues for proper internal healing.
The last photo shows apparent sinus tract formation which may be a smaller than before.

I would advise you the following in such a situation:
Avoid hot and humid atmosphere as this causes more sweating adding to the problem.
Use loose clothes and allow proper aeration of the area.
Apply pressure bandage soaked in Liquid Liquid Betadine till you see your Surgeon.
If possible push in hydrogen peroxide to clean the wound and then pressure dressing with a sterile gauze soaked liquid Betadine.
Take multivitamins and mineral as these help in healing.
All these may help to obliterate the tract and hasten healing for skin getting attached to the under-surface and thus have healing.

I hope this answers your query and helps.
Please let me know the feedback once you the Surgeon.

Take care.
Wishing you complete recovery.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. T Chandrakant 34 minutes later
Thanks doctor for your prompt reply.
Im not quite sure if he used laser or not but he only mentioned blue XXXXXXX during surgery to identify the tracts...i will apply what you mentioned and update you what my doctor says.
default
Follow up: Dr. T Chandrakant 0 minute later
Thanks doctor for your prompt reply.
Im not quite sure if he used laser or not but he only mentioned blue XXXXXXX during surgery to identify the tracts...i will apply what you mentioned and update you what my doctor says.
doctor
Answered by Dr. T Chandrakant 11 minutes later
Brief Answer:
Methylene blue XXXXXXX

Detailed Answer:
Thanks for your feedback.
The XXXXXXX is called Methylene Blue XXXXXXX and is used to lineate the tract before starting an actual surgery.

Awaiting for your update.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. T Chandrakant 0 minute later
Brief Answer:
Methylene blue XXXXXXX

Detailed Answer:
Thanks for your feedback.
The XXXXXXX is called Methylene Blue XXXXXXX and is used to lineate the tract before starting an actual surgery.

Awaiting for your update.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
default
Follow up: Dr. T Chandrakant 13 hours later
Doctor do you recommend me to apply MEBO oinment? or is it less effective than Betadine?
default
Follow up: Dr. T Chandrakant 0 minute later
Doctor do you recommend me to apply MEBO oinment? or is it less effective than Betadine?
doctor
Answered by Dr. T Chandrakant 1 hour later
Brief Answer:
I do not think MEBO ointment will help.

Detailed Answer:
Betadine is most effect and please use Liquid form.
Also follow the advise as give above.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. T Chandrakant 0 minute later
Brief Answer:
I do not think MEBO ointment will help.

Detailed Answer:
Betadine is most effect and please use Liquid form.
Also follow the advise as give above.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. T Chandrakant 28 hours later
Hello Doctor, today i saw my doctor and after showing him my groin area he said that usually this happens due to friction or shearing from wearing tight clothes sometimes and also to something rubbing on the groin itself....i may have walked alot after my travel....he mentioned that healing seems to need more time and the bursts that are happening some of them are due to some stitches still being under that weak skin needing to come out....so now he gave me a cream named "repavar" to apply twice a day for regenerating skin and oral antibiotics "Avalox 400mg" once a day for 7 days. once the 7 days pass i have to see him again to check progress...he mentioned no need for betadine as it might be destroying healthy bacteria as well....i couldn't get a detailed technical answer to what really happened or happening, what do you think doctor?
default
Follow up: Dr. T Chandrakant 0 minute later
Hello Doctor, today i saw my doctor and after showing him my groin area he said that usually this happens due to friction or shearing from wearing tight clothes sometimes and also to something rubbing on the groin itself....i may have walked alot after my travel....he mentioned that healing seems to need more time and the bursts that are happening some of them are due to some stitches still being under that weak skin needing to come out....so now he gave me a cream named "repavar" to apply twice a day for regenerating skin and oral antibiotics "Avalox 400mg" once a day for 7 days. once the 7 days pass i have to see him again to check progress...he mentioned no need for betadine as it might be destroying healthy bacteria as well....i couldn't get a detailed technical answer to what really happened or happening, what do you think doctor?
doctor
Answered by Dr. T Chandrakant 49 minutes later
Brief Answer:
As detailed below.

Detailed Answer:
Hi.
Yes, the shearing causes such problems as I have mentioned above.
Try to take rest, no such activities that can be avoided.
It takes time to heal such wounds at such places.
Your Surgeon might have put in approximating stitches that he is talking about and must be dissolvable hence nothing to worry about.
Repavar is fine. It helps in good healing.
Once the internal healing occurs, the would will close.
Occasional cases may need scrapping to remove granulation tissues.

Please post fresh photos.
Compression dressings help, try with sterile gauze.
Let aeration be there by using loose clothes.

I hope this answer helsp you further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. T Chandrakant 0 minute later
Brief Answer:
As detailed below.

Detailed Answer:
Hi.
Yes, the shearing causes such problems as I have mentioned above.
Try to take rest, no such activities that can be avoided.
It takes time to heal such wounds at such places.
Your Surgeon might have put in approximating stitches that he is talking about and must be dissolvable hence nothing to worry about.
Repavar is fine. It helps in good healing.
Once the internal healing occurs, the would will close.
Occasional cases may need scrapping to remove granulation tissues.

Please post fresh photos.
Compression dressings help, try with sterile gauze.
Let aeration be there by using loose clothes.

I hope this answer helsp you further.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on