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Dark Incisions should not be ignored!

Updated: Jun 15, 2023

When incisions go dark it is always a cause for concern.


It can be a sign of ischemia or lack of blood flow. If ischemia is not addressed the result will be tissue death known as necrosis. Necrotic tissue is a common complication of surgery where capillary blood flow is compromised.


For surgical sites, it may be a few days or weeks before soft tissue infection, ischemia and/or necrosis become apparent. Keep a close eye out on an incision line that continues to darken to purple and black and the area progressively splitting open.


You may be at a higher risk for necrosis if:

  • A large amount of skin was removed

  • Incisions are under a lot of tension

  • A high BMI. 30 and over will be at a higher risk for complications. See this free BMI calculator

  • Having Co-morbidities like Diabetes and circulatory issues like PVD, CAD

  • You are a smoker


What should you do if your incision is turning necrotic?

#1 Contact your doctor. Take a clear picture as they will want to see it.


#2 Get all the excessive pressure off! Compression garments can help to improve lymphatic flow and prevent excessive swelling but early in recovery a garment that is too tight, folding or cutting off circulation can be determental.


#3 Make sure blood sugar is optimized. High blood sugar affects healing skin and blood flow.


#4 Stop smoking. Smoking cause vasocontraction which also restricts blood flow.


#5 Add an Arginine supplement. Arginine is an amino acid that convert to nitric oxide that helps to open blood vessels and support blood flow. Here is an example to try


#6 Consider trying HBOT. Hyperbaric oxygen therapy treatments. Locations are popping up all over. It is an expensive and time consuming process but may be worth investigating.

Google "HBOT near me" and give them a call


#7 Get moving. You can not heal if blood is not flowing. Light exercise can be key to improving lymphatic and blood flow to support healing. Get out for some sun and fresh air and take a walk. If you are uncertain of how to start check out the home plan that includes nutrition, early movement and a personal video consult where we can customize your plan and advance that healing even further together.


#8 Red Light Therapy or LLLT may help to increase blood flow to the area. You may want to avoid the light right on top of the actual wound itself if it is blistered but around the area may be helpful. LLLT has been shown to increase new blood cell formation and increase immune response. Here is one that I use in my practice GET A RED LIGHT PAD use code HEATHERFLEXER for an additional 10% off.


#9 Tens units can help with blood flow and pain. Electric stimulation has been used for decades to help to heal wounds by encouraging cells to grow across the open area. The same is true for the pain and ischemia of a poorly healing incision. Just like the red light therapy it's an additional tool that may help the area from further breaking down. With fairly affordable options now readily available it is an easy treatment to do in between your appointments with your medical team and post-op care specialist. Bonus fact, when it's not being used for your incision, it's great for that back pain you may also be experiencing.


You can not heal a wound if blood is not flowing!


If you need support and do not have a wound specialist already, Let's chat!




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