Excision wound care and healing – a lesson in patience and sewing

If you’re following the blog, you know that I had an amelanotic nodular melanoma tumor removed from my knee in mid-late December. Because it was in a bendy spot, I had to get an elliptical excision. And because amelanotic nodular melanoma is the most aggressive form of skin cancer, they had to go pretty deep into my leg tissue to make sure they got it all. (Nodular melanoma differs from other melanomas in that it tends to grow deep roots rather than horizontally across the skin; skin cancer stages are based on the depth of the tumor and whether it has spread…)

I’ve already covered the excision process but I haven’t really talked about what came next. For two weeks after the excision, I was on pretty limited mobility restrictions. Ideally, I would have spent two weeks in bed with my legs above my hip level. While in theory this sounds great (enforced lady of leisure!), in reality – not so much. I mean, if I had a whoop-ass bed with tons of silk pillows, lots of reading material, my laptop, a small bell to ring when I needed something, and a couple of servants – then that might make it more enjoyable. But I needed to wrap some stuff up at work and for whatever reason, my lap is not made for a laptop. Plus, it was over the holidays and it’s damn near impossible to be immobile during that time of year.

For the past couple of weeks, I’ve spent some time bent over my knee checking out the doctor’s sewing. I never had stitches before and after this, not sure I want them. Regardless of how great the sewing was, the fact that I was constantly moving that area (I mean, I did have to go to the bathroom every once in a while) meant that the line of stitches shifted around a bit. And I have a big divot in my leg from where they removed a deep section of my knee so the stitches zig both horizontally and vertically. I don’t sew but I did get an appreciation on how hard it has to be to sew something that would need to account for movement.

My knee was bandaged with gauze and then a layer of stretchy adhesive bandage (like the old Ace wrap bandage but without the metal clips) on top to protect it. It worked pretty well. But then, about a week after the excision, I somehow managed to get the wound infected. Fortunately, it wasn’t some crazy flesh-eating bacteria (or even antibiotic-resistant bacteria); but damn it did puff up my wound area and make it super painful. Because it was right before New Year’s holiday, I had a few days delay on getting into the doctor (although she told me I could call her, my hubby had already discarded the wound care instructions – that had her cell phone number at the bottom…)

So for my follow-up two weeks later, when I was supposed to get all my stitches out, I instead got half of them out. She stopped because I was ripping the back off the exam table and making whimpering noises. It hurt like hell. She told me that it wasn’t supposed to hurt, and that the infection was the cause of the pain and swelling. She swabbed the area for a culture and gave me an antibiotic to take for a few days before I had to return.

Dutifully, I took my antibiotics and about four days later, was back in the doctor’s for round two of stitches removal. As soon as she walked in, the doctor was like “I got the cultures back and you need to switch to a different antibiotic”. All I could think of is, “Can you please take the rest of these damn things out first?” Fortunately, she did, although one area still hurt like a sonofa… and gushed blood like a broken water line as soon as she cut the stitch.

I’m now all bandaged up again and while I’m disappointed that I’m not completely done with the “wound care” phase of this, I am glad that I didn’t have any bigger complication than a garden variety bacterial infection. The doctor even said that it’s pretty common, especially in an area like the knee. But it also means no long bubble baths either…

Right now, the site is pretty gross looking. My husband says that he can’t believe how big of a scar I’m going to have from such a small pink spot. I just hope that the bruising and the swelling go down enough soon so I can start to find out if rubbing Vitamin E on a scar will make it less obvious. Like I said, I’m not the most patient in the best of times, but this post-excision phase is forcing patience…