Since 5 weeks left side has looked like this, there are no sutures actually coming out though. Today it started to open with some pus, but nothing at surface to pull out. Saw PS and he told me to keep gauze over it and do nothing since I have no fever and it does not hurt that bad. He said this will not affect my long term scar and over time it will heal well? I am concerned I should have it reopened to remove the sutures or it will not heal? Am I wrong? None at at surface enough to pull out.
Very Red Tummy Tuck Scar 8WPO, Do Nothing? (photo)
Doctor Answers (10)
Tummy tuck and problems with healing of the incision
To have redness, opening of the suture lines and having moderate drainage from incision lines, five weeks after surgery, are all indications for having infection. Often times referred to as " stich abcess". Occasionally this process strats off as a result of your body reacting or rejecting the suture materials. Your plastic surgeon could consider removal of what could be seen in your wound, irrigate it and advise to change dressing frequently. After a culture is obtained it is a good idea tp treat you with a large spectrum antibiotic.
Time heals all wounds - but sometimes the wounds will heal faster if suture is removed.
This does look like what is commonly seen with a "stitch abscess." Sometimes he will continue until this dissolving suture in the wound is removed. Often times in the clinic we'll carefully look within the open area to remove any visible sutures. It may be helpful to check back in with your plastic surgeon to see if there is any suture material that can be readily removed. Sometimes the wound just needs to heal on its own and will do so over time.
Wait for the active healing process to finish
Thank you for the question and the photos. You are currently actively healing. Once the process has been complete you will be able to decide whether a revision of your scar is needed. Surgery at this time would only be reasonable for a hematoma, fat necrosis, or large wound healing issue.
All the best,
Dr Remus Repta
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Redness of an abdominoplasty scar after an abdominoplasty
An abdominoplasty incision is quite long and it is not unusual to have some degree of wound healing problems. The dissoluble suture knots under the skin can occasionally get exposed and infected. At this point the suture knot acts like a foreign body and until it is removed this localized infection will not resolve. A wait and watch plan is common especially if you do not have any evidence of an invasive infection. If you develop a fever and chills as well as increasing pain and wound redness then a local exploration of the wound is indicated to remove the suture knot. You may, at this point, also need a short course of antibiotics. Keep in close contact with your surgeon for optimal care.
Slow healing after a tummy tuck
This is common after a tummy tuck. Sutures are beginning to melt away and sometimes this can cause a reaction.I would keep a close watch for a deeper infection. Possibly a wound culture a some point is not inproving.
Extruding Sutures After A Tummy Tuck
Very often in the 3 to 6 week period after a tummy tuck sutures will come to the surface and start to 'spit' . This is very confusing to patients because the suture line looked so good up until then. Unfortunately this is all too common on long body incisions. The sutures must work their way to the surface and, in this process, a local inflammatory reaction and even small suture abscesses will appear. Your surgeon will remove these extruding sutures as necessary. But this is a process that will take up to a month after they appear to completely heal. These usually have little consequence on the appearance of the final tummy tuck scar.
Tummy tuck redness
I think your plastic surgeon is taking a very prudent approach to your redness. I would start with the dressing changes as they have recommended. If things fail to improve then adding antibiotics and considering removing any irritating sutures would be the next step. Good luck.
Superficial Openings after Tummy Tuck Surgery?
Thank you for the question and pictures.
Although your anxiety is understandable, these types of superficial wounds are not infrequently seen after tummy tuck surgery. Sometimes sutures “spit” leaving temporary “holes” that generally go on to heal without long-term effect. Sometimes, on the other hand, sutures may need to be removed to allow the openings to heal.
Your best option is to continue to follow up closely with your plastic surgeon who is in the best position to advise you most precisely.
Very Red Tummy Tuck Scar 8WPO, Do Nothing?
This does look like what is commonly seen with a "stitch abscess." Sometimes by the time you see it the suture has already fallen out, but if so it should heal in days.
When I see something like this and can't feel the suture, I will usually inject some local anesthetic, and most times I do find a knot.
Assuming these are dissolving sutures, this won't go on forever.
Thank you for your question and photos All the best.