This article was medically reviewed by Erik Kramer, DO, MPH and by wikiHow staff writer, Amber Crain. Dr. Erik Kramer is a Primary Care Physician at the University of Colorado, specializing in internal medicine, diabetes, and weight management. He received his Doctorate in Osteopathic Medicine (D.O.) from the Touro University Nevada College of Osteopathic Medicine in 2012. Dr. Kramer is a Diplomate of the American Board of Obesity Medicine and is board certified.
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A tunnel wound is a secondary wound that occurs alongside a primary wound, and it's usually caused by an infection or pressure. This kind of wound extends into layers of tissue to form a hole or curved tunnel in your skin, so it can be a little unnerving to see! If you have a tunnel wound, keep the area clean and change the dressing regularly. Make an appointment with your doctor as soon as possible so they can examine the wound, identify the cause, and provide the right treatment. Tunnel wounds can take a long time to heal, so it’s important to work closely with your doctor to make sure everything goes smoothly.
Method 1Method 1 of 2:Dressing a Tunnel Wound
- 1Wash your hands with a mild cleanser for 15-30 seconds. Wet your hands with warm water, add cleanser, and lather up for at least 15 seconds to remove any bacteria from your hands. Be sure to get in between your fingers and under your nails! Rinse the cleanser away thoroughly and dry your hands off on a clean towel.XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source
- Infection caused by bacteria is one of the main causes of tunneling, so it’s crucial that you wash your hands and work in a sterile environment.
- An alcohol-based cleanser is a good option if you want to be certain that you've killed all the bacteria on your hands.
- 2Remove the old dressing carefully and put it in a plastic bag. Remove the medical tape holding the gauze in place and pull away the gauze carefully. If the gauze sticks to the wound, gently dampen the area with warm water and try again. To prevent the spread of bacteria, put the old dressing into a plastic bag immediately, seal it up, and throw it away quickly.XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to sourceAdvertisement
- 3Dampen sterile gauze or a soft cloth with saline or soap and water. Your doctor will tell you what to clean your wound with. If you haven’t seen your doctor yet, any mild cleanser will do the trick. Mix up a solution of warm water with a few drops of the mild soap, soak the gauze or cloth in the solution, and wring out the excess.XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source
- Always follow your doctor's instructions for cleaning and dressing a tunnel wound.
- 4Dab gently around the wound with the gauze or cloth to clean the area. Wipe away any blood, pus, and drainage from the wound and the surrounding area. Go slow and dab gently since tunnel wounds can be painful. If you have a deep tunnel wound, your doctor will instruct you to irrigate it with saline solution when you change the dressing.XResearch source
- Do not irrigate the wound unless your doctor tells you to. Hold the saline irrigation tip 4–6 inches (10–15 cm) from the wound. Squeeze the bottle or plunger to release a steady stream of saline. Sweep the tip from 1 end of the wound to the other and then back again to flush loose tissue, debris, and bacteria out of the wound. Aim to use at least 100 ml of saline fluid.XResearch source
- Never apply any type of lotion, cream, or herbal remedy on or around the wound unless your doctor specifically tells you to do so.XTrustworthy SourceMedlinePlusCollection of medical information sourced from the US National Library of MedicineGo to source
- 5Apply a fresh dressing according to your doctor’s instructions. The kind of dressing you use depends on the wound’s size, location, and drainage amount. Your doctor will tell you what kind of dressing to use and show you exactly how to apply it properly. If you haven’t seen your doctor yet, cover the wound with anti-microbial gauze for now and make an appointment as soon as possible.XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source
- Some tunnel wounds require packing with gauze to promote healing. Your doctor will show you how to pack your wound and how to order packing supplies.XResearch source
- If you do need to pack your wound, soak the gauze in sterile solution or use pre-moistened sterile gauze. Gently push the gauze into the wound to fill the empty space inside the tunnel. Then, cover the entire wound with dry gauze.XResearch source
- 6Keep your wound covered at all times to promote healing. It’s important to keep your tunnel wound protected from bacteria, so keep it covered with gauze or another type of dressing according to your doctor’s instructions. Try to change the dressing as quickly as possible to minimize how much time the wound is uncovered and only remove the gauze and packing to change the dressing.XResearch source
Method 2Method 2 of 2:Seeking Medical Treatment
- 1See your doctor immediately if you develop a tunnel wound. You can easily identify a tunnel wound by its "sink-hole" appearance near a primary wound. The "tunnel" appears as the infection eats through the top layers of skin and develops into a curved or S-shaped hole. Tunnel wounds are serious and require medical treatment, so it’s important to see your doctor right away.XResearch source
- Tunnel wounds are notoriously difficult to treat and can take weeks or months to fully heal. Don’t attempt to treat a tunnel wound on your own.XResearch source
- 2Tell your doctor your medical history and any details about your wound. Clearly explain to your doctor how you got the primary wound, when the tunneling began, what dressings you’ve been using, all of your current medications, and how much pain you’re in. Use as much detail as possible. If you have any medical conditions, like diabetes or anemia, it’s crucial that you tell your doctor about them.XResearch source
- For example, conditions like diabetes can inhibit the healing of wounds. Your doctor won't be able to properly treat your wound without this information.
- 3Allow the doctor to irrigate the wound and diagnose the cause. The doctor will irrigate the wound with a saline solution to clean it out and examine the wound closely for symptoms that help them make a diagnosis. For example, tunneling caused by infection will be inflamed and continually ooze fluid. Measuring the wound's width and depth helps the doctor fully assess the severity of the tunneling. Your doctor may need to order a CT or MRI to complete the assessment. Then, they will diagnose the cause of the tunneling and prepare a tailored treatment plan for you.XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source
- Common causes of tunneling are infection, improper dressing, diabetes, and prolonged use of antibiotics. The type of treatment you need depends on the cause of the tunneling.
- If your doctor suspects infection, they may perform a swab to identify the type of bacteria present. They can then prescribe the best antibiotic for that type of bacteria.XResearch source They’ll need to swab the inside of the wound to avoid picking up other bacteria on the surface of your skin.
- Blood testing is common, especially if you're diabetic or if your doctor suspects you might be. X-rays and ultrasounds can be helpful when diagnosing wounds that won't heal, especially for diabetics or people with chronic bone issues.XResearch source
- In addition to irrigating the wound, the doctor might wish to debride it (remove any damaged tissue or foreign materials) with a scalpel or other surgical tools.XResearch source While this sounds alarming, don’t worry—they’ll give you anesthesia to keep the procedure painless.
- 4Watch the doctor dress the wound so you can do it at home. The type of dressing your doctor uses depends on the wound’s size, location, and cause. It’s typical to pack the "tunnel" with sterile gauze to fill the empty space and absorb fluid before applying a covering to protect the wound. However, your doctor may use another kind of dressing, like a hydrogel, foam, collagen, iodine-based, or hydrocolloid dressing, depending on the situation.XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source
- Pay attention to how your doctor dresses the wound and ask any questions you have since you’ll have to apply fresh dressings at home.
- Use the type of dressing that your doctor recommends and apply a fresh dressing when your doctor tells you to. You may need to apply a fresh dressing daily or every 48-72 hours.XResearch source
- You may need to pack a tunnel wound for a few days or even a few weeks, depending on how fast the wound closes. You may need to keep the wound covered for 1-6 weeks, or possibly even longer, depending on how quickly and well it heals.XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source
- 5Follow your doctor’s instructions for treatment and follow-ups. Avoid putting unnecessary pressure or weight on the wounded area as it heals. Clean the wound and apply a fresh dressing every 24-72 hours, depending on your doctor's instructions. Be sure to take any prescribed antibiotics or other medications exactly as directed! The wound must be monitored regularly by your doctor as it heals, so be sure to ask about follow-up appointments and go ahead and schedule them, if possible.XResearch source
- Weekly measuring and monitoring of a tunnel wound is necessary to make sure it closes and heals properly, so don’t skip your follow-ups!XResearch source
- Your doctor may prescribe a powerful oral antibiotic like penicillin or amoxicillin if your tunneling is caused by an infection.XTrustworthy SourceWorld Health OrganizationHealth information and news provided by the World Health OrganizationGo to source
- Topical antibiotics may be given. Follow your doctor's instructions for applying these medications.XResearch source
- Prescription painkillers and anti-inflammatory medications are often prescribed to help patients manage pain and swelling.
- 6Manage any underlying conditions that might slow healing. If you have an underlying condition that affects how well your wounds heal, such as diabetes, work with your doctor to keep the issue under control. This will help ensure that your wound heals as quickly as possible.XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source
- If you’re diabetic, take any prescribed medications and monitor your diet carefully to keep your blood sugar under control. Talk to your doctor about how to monitor your blood sugar and what to do if it gets too high.XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source
- Other factors that can slow down wound healing include high stress levels, a poor diet, certain medications, obesity, and alcohol or tobacco use.XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source Talk to your doctor about how to improve your overall health to promote better healing.
- 7Discuss surgical treatment if your wound isn’t healing. In some cases, you may need surgery to help a tunnel wound heal properly. If you’ve tried more conservative treatments and your wound still isn’t improving, ask your doctor if surgery might be helpful for you.XResearch source
- The surgeon may open up the wound so that they can clean it out thoroughly or remove any damaged tissue or foreign objects that might be preventing the wound from healing.
- Always follow any special instructions from your surgeon about what to do before and after the operation. These instructions will help prevent complications and ensure that your wound heals as quickly and safely as possible.
- Always wash your hands thoroughly before and after dressing your wound.XResearch source
- Keep the wound covered and moist at all times.
- Eat a healthy diet and rest as much as possible to help your wound heal.
- If your wound isn’t healing well even with medical treatment, your doctor may refer you to a wound care clinic where you can get more specialized care.
- Tunnel wounds are serious and can take a long time to heal without the help of a doctor. If you notice tunneling near a primary wound, make an appointment with your doctor as soon as possible.
- Follow your doctor’s instructions for cleaning and dressing your wound.