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Why Isn't my Incision Healing? 4 Weeks Post TT/Muscle Repair. (photo)

I'm 4 wks po a TT with muscle repair. At 15 days po, after taking the paper take off to shower, it smelt horrible and was yellow discharge. Went to my ps and he said to put non stick gauze for a wk and clean with hy-peroxide and polysporn. did that for a wk and it looked nice, started taping on monday and by wednesday evening...same thing. took off the tape horrible smell and fluid poured out. It is red/raw about 3 "long in the middle of tummy. Isthis norm for 4 wk po? to be weeping still

Doctor Answers (6)

Fluid leakage for weeks after tummy tuck.

+2

Thanks for your questions and for the photograph.  First and foremost may I wish you a speedy and full recovery.

From what I can see the tissues appear to be alive and healthy.  The area right above the pubis is furthest away from its normal blood supply in tummy tuck and  sometimes this area can have develop dead tissue.  But this does not seem to be the case.

I see one of two possibilities and will divide them in two superficial and deep.

Superficial:

Most plastic surgeons use absorbable sutures underneath the skin to approximate the skin edge and the deeper tissues.  Sometimes, the body spits out the sutures, and some fluid with them.  If the sutures are contaminated with bacteria the problem will usually go away on its own as the sutures disappear.

Deep:

Sometimes surgeons use sutures that do not absorb too tighten the muscles of the abdominal wall.  If these sutures become infected they can lead to to a chronic drainage.  In this situation going in and removing the sutures that cause the trouble will generally solve the concern. If the abdominal wall sutures are indeed infected, but they are dissolvable the problem we usually go away when the sutures disappear.

Without knowing more about your surgery, and the kind of sutures that your Dr. used it's hard to know exactly whether the concern is superficial or deep.  You may wish to discuss with your Dr. getting a culture of the wound or the fluid that is expressed as it may guide antibiotic treatment if it becomes necessary.

Clearly, follow up with your surgeon is the best way to go for now.

 


Washington DC Plastic Surgeon
5.0 out of 5 stars 48 reviews

Not healing after surgery! (photo)

+2

You are experiencing the result of a fantastic innovation of organic chemistry, the development of "absorbable" sutures.  Although for the most part they do indeed resorb, your body sometimes extrudes all or part of these sutures for weeks after the procedure, in small abscesses that develop as your white blood cells mobilize in the area of the stitches to digest them.

Surgeons prefer absorbable sutures for "plastic" closures, because they allow us to place all stitches inside the wound, avoiding the possibility of external suture related "railroad track" scars along the course of the wound closure.

Alternatively, if you have a wound dehiscence, drainage will persist as fluid collects in a cavity deep to the skin closure, and intermittently pours out with changes in your position.  Wound dehiscence mandates drainage, or another approach, depending on the situation.  Your surgeon is the one to make this diagnosis, and follow through until the problem is resolved, and healing complete.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 38 reviews

Post op odor

+1

You may have an infected seroma. I always fear that when I hear about any post-operative malodorous drainage. That being said, definitely return to your plastic surgeon to have things checked out.

Christopher J. Davidson, MD, FACS
Wellesley Plastic Surgeon
4.5 out of 5 stars 12 reviews

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Wound healing problems after an abdominoplasty

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Healing problems are most likely due to exposed suture knots.  Once the knot becomes exposed it acts as a foreign body.  It will continue to give you  problems until it is removed.  This problem should be brought to the attention of your plastic surgeon.  

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Why Isn't my Incision Healing? 4 Weeks Post TT/Muscle Repair.

+1

Have you seen your surgeon? This is a very common occurrence as the previous expert osters stated. Local wound care is needed. 

Darryl J. Blinski, MD
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Superficial Separation along Tummy Tuck Incision?

+1

Thank you for the question and picture.

What you are experiencing is quite common at this stage in your recovery. The very superficial separation tends to occur exactly where it is occurring in your case. These superficial separations tend to be self limiting and resolve within weeks. However, continue to follow-up with your plastic surgeon who is in the best position to rule out more serious complications and/or advise treatment.

Best wishes.

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.