Explain further what you mean by "granulate from within". I know what granulate means, but how does the healing change between "normal" healing and when it is allowed to granulate?
Interesting.
DIV
Typically, surgical incisions are closed completely and cosmetically with sutures at the end of a procedure. When treating infections where an abcess has occurred, closing the skin after thoroughly cleaning out the area would allow pus to reaccumulate. In these cases, the entire wound can be left open, and it is typically packed with sterile gauze and covered. These dressings are removed and replaced each day using a technique called "wet-to-dry" dressing changes. The dressing is placed on slightly moist, and then it dries and adheres to the surrounding tissue. The next day when the dressing is removed, it peels off ("debrides") the dead tissue layer., As the bed of healing progresses, a beefy red tissue (called "granulation tissue") occurs, and less and less packing can be placed at each dressing changes The wound cavity gets smaller and smaller over time until the skin finally reepithelializes over it.
This type of healing can be very satisfactory, but certainly causes a lot more scar tissue not just at the skin surface, but also within the underlying tissue. Operating at a site of a previous area that has undergone this type of healing can be very difficult, as the tissue planes are all adhered together.
In many cases, the resultant surface scar is less than cosmetic in appearance. If you look at some of the pro bodybuilders closely, these areas are apparent. Again, I don't know if this is truly the case with Mr. Ruhl, but his scars in those areas would be very typical of a previous abcess.
