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docs - silver nitrate on a wound?

What exactly does silver nitrate do on a wound? The one time I saw it being used in person it seemed like a chemical burn was happening ....

I ask because the wife's c-section wound is healing very slow (normal for her) and a doc that was covering for her ob/gyn used silver nitrate not only on the exposed would surface but down into the wound tunnel. And now 36 hours later an area that had been healed along the tunnel "line" has re-opened with just larger than pin holes in a few places. Called covering doc on call, he seemed non plussed and thinks we can wait until early next week to get into the office. Should we push the issue tomorrow?
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Old 12-22-2010, 05:16 PM
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Who did the what now?
 
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Absofockinglutely.

If it does not happen tomorrow, it does not happen until Monday, if you are lucky. For now, I would suggest using some paper tape or something, perpindicular to incision line to reduce tension on the area and diminish chance of dehiscence(busting open). How large is wound, how deep is it and how long ago was surgery? When did stitches/staples come out? What sort of wound care are you doing to the area?

Silver nitrate will give a chemical burn, which is the black that you see when you use the applicator stick. I use it to control bleeding if I am debride(removing non-viable tissue from) a wound. The impact silver can have on wound healing is very interesting. It is anti-bacterial, and can actually stimulate healing. Ag used in a lot of wound care products.
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Old 12-22-2010, 05:46 PM
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1 month post op, no staples, no stitches to remove. Original wound was wide but shallow. Left half is completely closed, right half sealed over the top so we've been packing it w/ 1/2" and then 1/4" gauze strip (sterile, no additives). Tunnel has gotten shallower and opening smaller, things were looking good and just taking the normal slow healing that the wife normally has.

We'll be calling when the office opens in the morning.
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Old 12-22-2010, 05:57 PM
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Wifes first C did that.

Not good.

Besides the hassle of dealing with the open wound it left a bad scar that my wife was very self conscious about.

Upside is if you have another you can schedule a C and they can cut out the bad scar.
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Old 12-22-2010, 07:10 PM
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There are 2 primary ways a wound heals (for the most part): primary and secondary intention.

Primary intention is how most surgical incisions heal: the two wound edges are reapproximated (sutured together) at the end of the surgery, and they just heal together.

Secondary intent is how your wife's wound is healing. The skin edges either weren't closed or (more likely in a C-section) the skin edges dehisced--came apart. That can happen for various reasons. But when that happens, you don't want to sew the skin edges back together. You have to let the wound heal from the "inside out." So you pack the open space of the wound, as you're doing, and let the tissue underneath the skin fill in. That tissue ideally is a beefy red, lumpy tissue (called granulation tissue). Eventually the wound will granulate in and the skin edges will come together. It'll just take time. The bad part is that it'll take time, and the scar won't be as cosmetic (which can be dealt with later, if so desired).

Silver nitrate is a chemical which burns tissue. It can be used to debride (get rid of) not so healthy skin and soft tissue and allow the healthy stuff underneath to fill in. It's not discriminatory, so whatever it touches/poisons, it'll kill (healthy and unhealthy tissue, alike). Just touch it to the stuff you want to kill. A few days after application, the affected tissue will turn black or grey and come off.
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Old 12-22-2010, 07:49 PM
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This happened to my wife too.

She says "Hey, it kind of hurts here, can you take a look?"

I said "sure!"

Then I was like

And then like

"Um, it looks . . . ok . . . but there is a hole . . . ."

We did visit the Dr. though and he cleaned it up. It healed fine and fairly quickly from the inside out when cared for per doctors orders.

Fortunately it did not happen with the second C-section. I've heard its fairly common though.
Old 12-23-2010, 05:38 AM
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This is an issue with any would the wife has had in the 18 years we've been together. Just the way she is.

Fortunately, I worked for a long time in an acute care PT department and did plenty of wound care...
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Old 12-23-2010, 08:30 AM
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