Can a surgical wound heal from the inside out?

Written by WISH Clinic

Clinically reviewed by Dr. Traci A. Kimball, MD, MBA

Last medical review

Yes. A surgical wound left open heals from the inside to the outside, and the dressing keeps the skin from closing before the wound underneath fills in.

Not only can it, that is how a surgical wound left open heals. The wound will heal from the inside to the outside.

The next part is the one worth keeping, because it reframes something patients often misread as bad news. A dressing helps absorb drainage and keeps the skin from closing before the wound underneath fills in.

Keeping the skin from closing. The dressing is not only protecting the wound; part of its job is to stop the surface sealing over too soon. A wound surface that closes early is something clinicians actively work to prevent, which is the opposite of how it tends to look from the outside.

Healing in general follows the same filling process for wounds of all kinds. The body repairs broken blood vessels, and new tissue grows over the next 3 weeks or so. The wound starts to fill in with new tissue called granulation tissue. New skin begins to form over this tissue. As the wound heals, the edges pull inward and the wound gets smaller.

This is also why packing exists. Gauze pads or packing tape are placed into the wound, carefully filling in the wound and any spaces under the skin. As the wound heals, you should not need as much gauze or packing. The reducing amount of packing is a measure of the filling.

None of this means a particular wound is healing as it should. Depth is measured at an examination, and a wound that seems to be filling slowly is a question for the people measuring it.

What to watch for

As the wound heals, you should not need as much gauze or packing gauze. Needing steadily more, rather than less, is a change worth reporting.

Contact your provider if the wound is larger or deeper, or looks dried out or dark, and if drainage increases or becomes thick, tan, yellow, green or smells bad.

For a surgical wound being managed open, the temperature figure is 100.5°F (38°C) or higher. That figure belongs to this kind of wound; other wound types have different figures.

Wound Wizard is general education and cannot assess your wound or how it is filling. Your own clinician is the right person to ask.

What we look at

  • Measuring the depth of the wound at each visit
  • Judging how well the wound bed is filling
  • Adjusting the packing as the wound gets smaller
  • Checking for infection

Related questions

Sources

  1. Surgical wound care - open — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000040.htm
  2. Wet-to-dry dressing changes — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000315.htm
  3. How wounds heal — MedlinePlus, U.S. National Library of Medicine https://medlineplus.gov/ency/patientinstructions/000741.htm
Non-healing wound care at The WISH Clinic

The Wish Clinic®

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