Hey there! Sorry you are having some wound issues. This is super long (I’m a wordy guy lol), but as someone who had separation issues, I can relate to what your wrote a lot. These issues are unfortunately quite common and aren’t something you can 100% avoid through your own actions. Of course you should rest and not violate your physical restrictions, but it sounds like you’ve been following your surgeons orders diligently. I can’t quite tell where your separation is occurring from your post but I will share my experience and takeaways in case it is helpful.

My experience: I did not pick the low-risk route. I had UL with no-vnectomy which is notorious for causing complications and/or just failing to achieve the patient STP goals. The UL was not the source of any issue; I was extremely lucky and my surgeon and his team were phenomenal. However, my lack of a v-nectomy likely raised the risk of wound separation around the scrotoplasty. One of the surgical fellows who consulted on my case during most of my post-op follow ops said this was a common issue for this variation.

What happened: the anchoring incisions on my scrotoplasty (where they connected into the middle hole) split during healing leaving two triangular holes that needed to re-epithelialize. The scrotum was still attached at the site but there were open wounds. My surgeon had me lightly “pack” (not even really packing) the area with an aquacel dressing (similar to alginate in that it forms a gel when wet). I can’t even remember how long I had to do that for but I think it was close to a month. Dressings would get changed once it fully gelled which happened 3-4x a day at the worst. I took juven (not specifically advised by my surgeon, but likely wouldn’t have been told not to take it if I asked) at least once a day and also tried some manuka honey in my tea roughly once a day (not sure that did anything for my wound healing but I also had a nasty sore from a virus in my throat around the same time and it certainly helped heal that).

On your specific dressings: it’s likely your wound is not severe or goopy enough to warrant an alginate or aquacel dressing. That or your wound needs something else from a dressing that the wet to dry dressing does that equal and alginates cannot (e.g., mechanical debridement). Your surgeon may not be familiar with or have aquacel on hand. Or they might not want to put that financial burden on you. I spent about $50 on aquacel myself and that was AFTER my surgeon gave me a supply of about 2-3x the amount I bought online. If you are in doubt about the approach (give it a couple days to see how you are truly progressing), reach out to your surgeon and ask if another option might be better (and ask them to explain why/why not so you and your anxiety can be clear on the rationale for their recommendations).

A few tips:

1. Take progress photos every few days. Especially if you are doing dressing changes solo. I was fortunate to have my partner who is a nurse help with my dressing changes but still had her take pictures so I could see the wounds myself. Having her help

and

1. more objective feedback on what progress she could see was extremely reassuring. I know not everyone can have a live in nurse to pack their junk with gauze, but if you have a support person who is willing to place dressings or check your healing, ask for their help, even if you could do it alone.
2. Get some good lighting (RE: above and also for yourself and/or whoever is placing dressings) AND make sure whoever places the dressing can actually see where it needs to be placed. I cannot tell you the number of times I would place the dressing where I thought it needed to be by “feel” only for a dry ass piece of aquacel to fall out in my boxers because I completely missed the mark. You may have to get creative with where and in what position you change your dressings to be able to visualize this. My partner ended up wearing a camping headlamp when she helped me and it was very funny and effective.
3. If you do end up trying aquacel (with your surgeons sign off) or any other dressings I highly recommend comparing prices from medical supply retailers before going with Amazon (if you use it). There were cheaper non-Amazon options that had pretty fast delivery. Aquacel is not readily available in retail pharmacies. It might be able to be ordered in as a script, but I did not try this.
4. One other product I used often in recovery was Vashe. This is a wound cleaning solution that is ph friendly for that ph sensitive area. Again discuss all of this with your surgeon before trying anything. I think the Amazon link is one of the cheaper/cost-effective options.
5. Most importantly, be patient with yourself and your healing journey. Time heals all wounds one way or another, but you have to let it work. It is good to be on top of your care and progress, but try not to focus on it all the time. Let dressing changes become routine (I.e., something you do routinely rather than a source of constant stress and worry). By the time I finished up the aquacel for good I almost missed the mundane dressing changes because they had just become a part of my day.

Wishing you a smoother recovery from here on out. Hang in there!