Tunneling wounds can be tricky to identify, as most of the tearing and damage occurs out of sight, beneath the skin. Wound tunneling can also extend the healing process much longer than normal as the torn flesh shifts with use, allowing for a buildup of dead skin and infection. A tunneled wound should be cared for as soon as possibly by a proper medical authority. Any wound can experience tunneling, especially those caused by cuts, puncture or other forms of damage that impacts more than just the surface layer of skin.
Tunneling means that a wound has channels extending from the central injury into the surrounding tissue, such as muscle and skin. These tunnels inhibit the wound’s healing rate, as the flesh is unable to maintain contact long enough for the mending process to initiate. Wound tunneling also can allow for abscesses—collections of pus—to form within the tunnel cavities, causing extended infection.
According to Dr. Laura Barnes, a skin care coordinator at Silver Cross Hospital, there are several reasons wound tunneling may occur. One scenario is through pressure on the wound which tears inner layers of skin apart. Also, dehydration of a wound may cause the skin to pucker and pull apart. The swollen flesh pushes away from itself when a wound is infected and inflamed, resulting in further tunneling.
Wounds are best treated by trained physicians. Common techniques for treating a wound tunnel involves cleaning the wound to avoid further infection. The wound is then filled with sterile packing to try and prevent abscesses from forming and prolonging the healing process. At this point, it becomes a matter of maintenance over a course of weeks or potentially months as the tunneled wound heals. Packing is replaced as required, and the wound is kept as clean as possible.
Medical equipment and tools used in the treatment of wound tunnels can include measuring devices (such as rulers or even tape measures) to determine the size of the wound, sterile dressing, gauze and antibiotic gels.
Most healthcare professionals such as doctors and registered nurses have the training to treat wound tunneling. The American Academy of Wound Management provides further training for Certified Wound Specialists, and anyone from physicians to nurses to physical therapists can reach this level of education and skill.