So, the final part of the journey was a revisit to the wound.
It is not clear in the image, but there is a flap of skin filled with adipose cells, which was both uncomfortabe, and prone to being pinched. At a visit with my surgeon JR (Jeremy Rawlins) in September 2018, he advised that he could fix this, and to expect surgery in January 2019. Four days later I received a call from Bentley Hospital advising that there had been a cancellation, and surgery was booked for three days later.
A week later at clinic, the wound looked good and was healing nicely. I was advised I could be back on my bike within a couple of weeks.
A week after the clinic visit, I went to the loo in the dark, but felt my leg was slimy. When I turned on the light I saw what had happened. It took me a while to recover from the surprise of what I saw. The wound had dehisced, that is the wound had unzipped and opened up. I had had a dehiscence of my previous wound, but they were 10mm wide, this was a triangle of over 70mm to a side.
A few hours later, I was at Royal Perth Hospital Emergency Department, it was about 3am. I was advised I would need to wait for the surgeons to come in to work at about 9am to assess me. The image shows a nurse taking a swab to check for infection, and also to show the scale of the wound.
The surgeons arrive, and decide not to admit me, but to use the spare operating room in Emergency, to stitch me up. It was a funny experience, as it was currently being used as a storage room, and within 30 mins they set it up as a sterile environment. The beds and lights were already in place and we were ready. A local anaesthetic was all that was needed, and the procedure took 90 minutes to clean, and close the wound.
A few days later I noticed another dehiscence happening between two sutures, as seen here.
And a few hours later, it pops open.
So, back to Emergency department.
This is now what they call a cavity wound, and it cannot be stitched up as before. Lymph fills the hole, which in this image has a depth of 15-20mm, and since I now have no lymphnodes on that side, the lymph inhibits the healing of the cavity wound, which must heal from the bottom up.
So, the solution is a low pressure (vacuum) wound management tool. This neat device fits over the wound and sucks the lymph up, and stores it within the unit container.
One needs a home visit nurse (or a visit to clinic) every two days, over a period of several weeks, where the dressing is changed, and the wound depth is measured.
Nothing seems to change for a while, although the wound is healing from below. Eventually the depth of the cavity wound becomes zero, and the wound it ready to close up.
The last of the sutures are removed, and the lovely pink wound is ready to close over.
It takes another three weeks, and the wound finally heals completely.
I am itching to get back on my bike, but I am warned that another dehiscence is possible, and that I should wait for another month to allow the wound to bind as much as it can.
I will also have to build up my exercise regime slowly, so as not to strain the whole area too much.
But it has healed, although it took 6 weeks longer than I ever expected.
