Diving in salt water with a healing wound?

[wmspdi]

I ran a search and didn't find what I was looking for, so it is time to ask for a second opinion. I have a family dive trip booked for April 11th - 19th in Ft. Lauderdale. The goal of the trip is to give my son (a new OW diver) his first taste of salt water diving. We plan on starting on the shallow reefs off of Lauderdale by the Sea, and if he does well wrap up with few boat dives. The problem is I have a hole in my leg!

The backround info: 4 weeks ago I had a mole removed from my shin. 12 days later the surgeon removed the stiches. I thought it a little too soon, with the tightness of the skin in that area, but he is the doctor. 2 days later the wound ripped open. He looked it over, said he could not close it again because of the risk on an infection, and told me to wash it daily, bandage it, it would heal and that he wanted to see me in two weeks (that was today). Well the wound is healing from the bottom up as expected, but it has opened a lot wider now. He now has me "wet to dry" packing it twice a day to speed things up, but says it won't be healed in the 16 days before my trip... hence I will have this hole in my leg when I go diving. I should say that there is no pain from the wound.

Back to my question... The Dr. says that since it is an open wound it should not become infected. That I can dive in the ocean, and just was it with soap and water when I am done, and bandage it. This seems to fly against what I learned in my Rescue Diver first aid classes about open wounds and infections. I am concerned about the organisms in the salt water... in particular the Miami/ Ft. Lauderdale beach areas (they have been known to close the beaches do to high bacteria counts). Since the Dr. blew the call on removing the stiches, than blew the call on doing nothing afterward (until the wound opened up even more) I am looking for a second opinion on this call (third time's the charm). BTW- going to my General Practitioner won't help, he is this doctor's father (although not in practice together). I need to know if I should cancel or delay the trip. Are there other options? thanks.

 

[dutch-scuba-kid]

I went diving with a wound once. It wasn't quite as big as yours, but it felt like it was healing quicker after it 'reacted' with salt water. Or is that all just in my head?? I really felt swimming/diving in salt water helped the wound of not getting infected...
Maybe I'm just crazy, and I'm certainly not a doc. Hmm... maybe better let somebody else answer this for you. I'm starting to really doubt myself now.
Good luck.

 

[Laurence Stein DDS]

In most cases, 6 weeks would be more than enough time post surgery on a superficial skin lesion to be sufficient to allow you to dive. The surgery site may be depressed and the skin may not have completely matured but primary healing has occurred. This wound is healing by secondary intention. Another words, a scab has formed across the wound and the edges fill in toward the center. This takes longer than healing by primary intention...skin edges are brought together and sutured. The skin only has to heal across the incision line.

You're going to have a depression in a wound of this type. You might want to keep the area covered while diving. The sun will discolor the healing site and make the scar more obvious.

There are all sorts of great waterproof bandaids available now that stay on really well. If you want to cover it during the dive, this will not cause a problem.

Regards,

Laurence Stein, DDS

Now, if there is infection, pus, etc. you may well have to wait. But as I read your description it is healing uneventfully.

 

[beche de mer]

I agree with your doctor on this one.

There are potentially pathogenic organisms in the water, particulary around reefs. But most cuts that become infected do so because they are directly innoculated with organisms through a coral cut, urchin spine or sharp edge of shell.

You'll just have water washing over your wound. I don't think there's much risk of infection.

 

[Scubamedicjoe]

keep it covered with some of the new bandaids and have fun watch it and keep it as cleans as possible

 

[gazzahawkes]

hello,

Tricky one this.Some people state that diving with wounds in salt water can accelarate healing.This can be true to a degree in cold CLEAN salt water.

Where I work as a dive medic this is a common problem from instructors needing to work with cuts etc.Here The advice is do not dive till wound is healed and fully closed.Here the water is 28 to 30degrees and full of bacteria from the reef secondary infection will happen in almost every case ,We have photos and case studys on people who have started with nothing more than an open mosquito bite that has devolped into three inch ulcerations after two days diving.

A simple rinse of the wound will not clean it effectivly it will need coleaning down to raw healing tissue this in itself will delay healing as the new tissue will be removed whilst cleaning.

personally I would think of water quality if filthy as suggested in your post dont dive.
No bandages or plasters will stick on under water and seal wound.If the wound is small try some second skin. (Areosole used for burns and grafting.)spay it over wound it will sting like a ***** but will keep water out remeber the wound must be sterile before applying and must be cleaned after.

hope this helps.

kind regards
gary

 

[gehadoski]

keep it as clean as possible, don't warry cause salt water will help it to get well faster. Take care because this part will be too sensetive and can ripe again, take care if there are sharks in the area cause you may bleed alittle.

It happened to one of my friends in the brothers island but he was lucky is that shark attack, and it was because a wound in his arm.

 

[Scubamedicjoe]

have to disagree with this
"No bandages or plasters will stick on under water and seal wound" I have used several of the water bandages and then seal them up depending on location with yes a bread bag if lower part and taped andworked just fine its really a judgment call , biggest thing is keep it clean and well rinsed .

 

[pasley]

...Since the Dr. blew the call on removing the stiches, than blew the call on doing nothing afterward (until the wound opened up even more) I am looking for a second opinion on this call (third time's the charm).

Not my area of expertise, but since when has that ever stopped me from having an opinion.

No comments on the dive trip other than if it were me, I would be very upset right now and trying to change my trip dates. I would also be looking for another doctor as this one certainly blew it. I think your comments on him not taking the pressures on that area of skin were right on the money. Perhaps a self dissolving thread would have been in order.

 

[ElectricZombie]

I had a toe nail removed a day before a dive trip once. I went to Walmart and bought some of that brush-on liquid bandage stuff that was waterproof. I put a few coats on and it did not come off during the dive. That stuff really works; no infection and it seemed to speed up the healing process.