What it is
A surgical wound is an incision made during an operation, usually closed with stitches, staples, glue or strips. Most heal in an orderly way. A surgical wound not healing is one that stays open, reopens, drains for a long time, or seems to make little progress as time passes.
Healing can stall for many reasons. Clinicians commonly look at things such as infection, pressure or tension on the incision, poor blood flow, swelling, nutrition, other health conditions, certain medications, smoking, and whether something like a stitch or implant is affecting the area. Often more than one factor is involved.
Terms you may hear include dehiscence (an incision that has partly or fully opened), a surgical site infection, a seroma (a fluid pocket), or a chronic or non-healing wound. Only a licensed clinician can tell which applies after examining the wound.
How it’s traditionally been approached
Traditionally, the surgical team that performed the operation is the first to check an incision. They look at how the wound appears, review the person's overall health, and decide whether it needs closer follow-up, testing or further care.
Wound care has long involved keeping the area clean, managing drainage with dressings, relieving pressure, and treating any infection a clinician identifies. Some wounds are left to heal gradually from the bottom up, while others may be re-closed by a surgeon. Which approach fits depends on the wound and the person.
Over time, additional tools have become part of the conversation, such as negative pressure wound therapy, which is well established, along with other advanced dressings and, in some cases, skin substitutes or hyperbaric oxygen for specific FDA-cleared indications. Whether any of these is appropriate is a decision for a licensed clinician after an evaluation.
How the right wound care specialist may help
A wound care specialist is a licensed clinician who focuses on wounds that are slow to heal. A visit generally includes a review of your surgery and health history, a list of medications, and a careful look at the wound, which may be measured, photographed or gently assessed for depth and drainage.
Specialists may look for what is getting in the way of healing, such as infection, circulation problems, swelling or pressure, and may coordinate with your surgeon, primary care provider or other professionals. They may sometimes remove non-viable tissue, choose a dressing, or discuss other options. These are possibilities, not promises, and what happens depends on your situation.
Good questions to ask a licensed provider include: What do you think is causing my wound not to heal? How would you describe its stage or type? What treatment options exist and what are their pros and cons? How long might healing take? What will insurance cover? What signs mean I should call you right away? If a product such as a skin substitute or amniotic graft is mentioned, ask about its FDA status and coverage. Amnioticdoctors.com offers further reading on amniotic products specifically and is not affiliated with WoundKare.
The whole-person view
Body, mind and stress affect one another. A wound that won't close can bring worry, frustration, poor sleep and pain, and stress and poor rest can in turn affect how the body feels during recovery. Looking at the whole person, including nutrition, movement, rest and emotional well-being, is part of how many clinicians think about healing.
If the body feels tense or on edge after surgery, body-based support such as that listed through Somatic Experiences may be one option some people explore. If worry or low mood is weighing on you, talk therapy through Therapists.plus may offer a place to process it. These can complement, never replace, the care of your medical team.
Somatic Experiences: trauma and emotional healing →Therapists.plus: mind body connection →
Keep in mind
- Seek medical care promptly for any sign of infection: spreading redness, red streaking, increasing warmth or pain, pus, a foul odor, fever or chills, or a wound that is quickly getting worse.
- Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis (such as confusion, rapid heartbeat or very high or low temperature with feeling severely ill), or a deep or severely contaminated wound.
- Licensed professionals should guide all wound care decisions; do not stop or change anything your surgeon has told you without talking to them first.
- If distress ever feels overwhelming or you're in crisis, call or text 988 to reach the Suicide & Crisis Lifeline.
Not sure where to start? Answer a few gentle questions and choose who you’d like to hear from.
Frequently asked questions
Why is my surgical wound not healing?
There isn't one single reason, and only a licensed clinician can tell you for your wound. Common factors clinicians consider include infection, tension or pressure on the incision, reduced blood flow, swelling, other health conditions, medications, smoking and nutrition. An evaluation helps identify which may apply.
How long should a surgical wound take to heal?
Healing time varies widely depending on the type of surgery, the location of the wound and your overall health. Rather than relying on a general timeline, ask your surgeon or wound care provider what is expected for your wound and what would be a sign that it is taking too long.
What are signs a surgical wound is infected?
Signs can include spreading redness, red streaking, increasing warmth or pain, pus, a foul odor, fever or chills. If you notice any of these, seek medical care promptly. Heavy bleeding or feeling severely ill is an emergency, so call 911 or go to the ER.
When should I see a wound care specialist for a surgical wound not healing?
Many people consider it when an incision has opened, keeps draining, or shows little change over time, ideally in coordination with their surgeon. A primary care provider or surgeon can advise whether a referral makes sense for you. Don't wait if there are signs of infection.
What can a wound care specialist do for a wound that won't heal?
A specialist may evaluate the cause, assess the wound, and discuss options such as dressings, managing infection or swelling, negative pressure wound therapy, or other approaches. What is appropriate is decided by a licensed clinician after an evaluation, and results can't be guaranteed.
Will insurance cover wound care for a surgical wound?
Coverage differs by plan, provider and the specific treatment or product. Ask your provider's office and your insurer ahead of time what is covered, whether referrals or prior approvals are needed, and what your costs may be.
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.