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What are Tunneling Wounds?

The sight of an open wound can be uncomfortable for some but what many of us don’t realize is that what’s underneath can be even more unsettling.

Tunnels beneath the skin may indicate that the wound is not healing as it should and since tissue damage is present, serious complications may occur without proper and timely care.

What are tunneling wounds and what treatment options are available for such?

What are Tunneling Wounds?

A tunneling wound is defined as a wound that has progressed enough to create passageways under the skin’s surface. These tunnels can come in different shapes and forms. They can be long, short, deep, shallow, and may even take some twists and turns on some occasions.

These wounds extend from the initial injury deeper into the surrounding tissues, such as skin layers and muscles. These tunnels can be caused by a number of factors, all of which disrupt the normal wound healing process.

How is a Tunneling Wound Diagnosed?

It’s important to emphasize that tunnels aren’t always visible and that they may still exist even if the wound only appears to affect the skin's surface. Without proper care, these “surface” wounds may end up becoming a tunneling wound.

Tunneling wounds require proper treatment to keep them from getting deeper and stop new tunnels from forming in the process. If left untreated, a tunneling wound can lead to more tissue damage as well as infections that can lead to further complications. They can even be life threatening in some cases.

It’s best to pay the doctor a visit so they can probe the wound and determine if tunnels exist and if so, how deep or long they are or what direction they are headed.


Several factors can contribute to the formation of a tunneling wound and below are some of them.

  • Smoking

  • Chemotherapy

  • Sedentary lifestyle

  • Immunosuppressant drugs (they can hold back wound contraction and protein synthesis)

  • Corticosteroids (they can hold back collagen formation)

There are also several medical conditions that can slow down wound healing such as:

  • Alcohol use disorder

  • Advanced age

  • Compromised immune system

  • Diabetes

  • Malnutrition

  • Obesity

  • Rheumatoid arthritis

  • Venous insufficiency

  • Zinc deficiency

Treatment Options

There are many factors to consider in determining the right treatment option for a tunneling wound. Primarily, knowing its cause will help identify the kind of treatment that best suits the situation.

Since a tunnel can go through several layers and curve in so many different ways, a careful examination of the wound is imperative. Sometimes, imaging tests may even be necessary for doctors to better understand the full extent of the wound.

Packing and dressing - such type of wound needs to be packed firmly to prevent it from caving in.

Medication - pain medicines, antibiotics, phenol injections, and antibiotic creams.

Draining - this can help promote granulation tissue formation which is responsible for closing up the wound.

Management of pre-existing conditions - managing underlying health conditions or comorbidities will also help. If you have diabetes for example, constantly checking your blood pressure will go a long way in not just preventing tunnel formation but also in speeding up the wound healing process.

Surgery - different surgical techniques may also be helpful especially in the removal of damaged tissues and cleaning up of tunnels.

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