I looked at things outside of the axe wound, such as the skin creases around the arse, the discoloration of the anus, texture of the skin, texture of the body hair, wound length, etc.
It does appear swollen, infected, and not healing properly. It's pretty clear he has ripped quite a few stitches based on what stitches are visible and loose, the fresh bleeding, wound length.
It appears he ripped the stitches of where the taint should have been sewn securely shut based upon the non-spread shot of the faux labia majora. There is a clump of skin near the anus that has clearly ripped which is the section of the open wound in the stink ditch spread image and also where there is that secondary slit his tagged that random dr about.