What it is
Surgical wounds are cuts made on purpose during an operation, usually closed with stitches, staples, glue or tape. Most close and heal in an expected way, but some edges separate, drain, or stay open longer than expected. When an incision opens back up, clinicians often call it dehiscence.
Traumatic wounds happen unexpectedly. They include abrasions such as road rash, where the top layers of skin are scraped away, as well as cuts, punctures, tears and crush injuries. Motorcycle, bicycle and fall injuries can leave wounds that are scraped, embedded with dirt or gravel, or deeper than they first look.
Many things can affect how a wound heals, including blood flow, infection, pressure, nutrition, other health conditions and some medications. Surgical site infection signs include spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills. Because every wound and person is different, a licensed clinician needs to evaluate the cause of a wound that is not progressing.
How it’s traditionally been approached
Wound care has long centered on a few ideas: keep the area clean, protect it, and give the body the conditions it needs to heal. Clinicians usually start by assessing the wound's size, depth, drainage, surrounding skin and the person's overall health.
Debridement is the removal of dead, damaged or contaminated tissue from a wound so healthy tissue can be seen and healing conditions can be assessed. It has traditionally been done by trained clinicians in several ways, and which approach is used is a clinical decision. Traumatic wounds with embedded debris are often cleaned and evaluated carefully for this reason.
Other approaches commonly discussed include specialized dressings, negative pressure wound therapy (a well-established method that uses gentle suction), compression, offloading pressure, and managing infection. Skin substitutes and amniotic or placental grafts are also used in some settings. Their FDA status varies, as most are regulated as minimally manipulated tissue rather than FDA-approved drugs, and coverage differs by product and payer. Amnioticdoctors.com is one source for further reading on amniotic products specifically, and it is not affiliated with WoundKare.
How the right wound care specialist may help
The right wound care specialist may help by looking at the whole picture: what is slowing healing, whether infection or poor circulation may be involved, and which options might fit your situation. A visit often includes a review of your history and medications, a close look at the wound, and sometimes measurements or photos to track changes over time.
Specialists may also explain what they see, discuss whether debridement or other in-office care is appropriate, and describe what you can expect at follow-up visits. Whether any approach helps depends on your individual circumstances, and no outcome can be promised.
Questions worth asking a licensed provider: What is causing my wound to heal slowly? How is it staged or classified? What treatment options exist, and what are their pros and cons? What is the expected healing time? Which products are regulated how, and what will my insurance cover? What signs should prompt me to call you right away?
The whole-person view
Body, mind and stress affect each other. A wound that will not heal can bring worry, poor sleep, pain and frustration, and stress, sleep and overall health can in turn influence how the body recovers. Looking after the whole person is a reasonable part of any healing journey.
Some people find body-based support helpful for calming a stressed nervous system, such as the approaches listed by Somatic Experiences. Others value talking through fear after a traumatic accident or a hard surgical recovery with a counselor, and Therapists.plus can help you find talk therapy. These are supportive options that sit alongside, not in place of, professional wound care.
Somatic Experiences: trauma and emotional healing →Therapists.plus: mind body connection →
Keep in mind
- Seek medical care promptly for signs of infection (spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills) or a wound that is rapidly worsening.
- Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis, or a deep or heavily contaminated wound, such as from a serious accident.
- Only a licensed clinician can evaluate a wound and decide what care is appropriate, including debridement, dressings or any medical product.
- If distress after an injury or surgery feels overwhelming, call or text the 988 Lifeline at any time.
Guides in this topic
Wound care specialist types
Frequently asked questions
Why is my surgical wound not healing?
A surgical wound not healing can have many possible causes, including infection, reduced blood flow, pressure or tension on the incision, other health conditions, some medications and nutrition. Only a licensed clinician can tell which factors apply to you after an evaluation. Contact your surgeon or a wound care specialist if an incision stays open, drains or looks worse.
What are the signs of a surgical site infection?
Surgical site infection signs include spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills. If you notice any of these, seek medical care promptly. Call 911 or go to the ER for signs of sepsis or heavy bleeding.
What is dehisced surgical incision treatment?
Dehisced surgical incision treatment depends on how far the wound has opened, whether infection is present and the person's overall health. Clinicians may evaluate the wound, clean it, and decide whether it should be left open to heal, dressed in a particular way or closed again. A licensed provider should make that decision, so contact your surgeon or a wound specialist promptly if an incision opens.
How is road rash wound care usually approached?
Road rash wound care generally starts with a professional look at how deep the abrasion is and whether dirt, gravel or other debris remains in the skin. Clinicians commonly clean the wound, remove debris and choose dressings suited to the injury. Because embedded debris and infection are real concerns, have a licensed provider evaluate road rash, especially if it is large or deep.
What is traumatic wound debridement?
Traumatic wound debridement is the removal of dead, damaged or contaminated tissue from an injury so clinicians can better assess it and support healing conditions. It is performed by trained clinicians, and the method depends on the wound. Ask your provider why it is recommended, what to expect and how follow-up will work.
When should I see a doctor after a motorcycle accident wound?
Motorcycle accident wound treatment should involve a professional evaluation, because these injuries can be deeper or more contaminated than they look. Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, a deep or heavily contaminated wound, or signs of sepsis. See a provider promptly for any sign of infection or a wound that is worsening.
Educational resource. WoundKare shares general information and connects people with independent wound care specialists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.