Delayed wound healing: big hole. Will I stay having a big hole? (Photos)

Question

Again, I'm freaking out because it's such a big hole. pS said it's fine, it'll heal. Gavw mw proper instructions for wound care at home, twice a day with peroxide, then Spray with microdacyn (I believe it's that name). I was also instructed to loosen my girdle to let blood flow & sometimes take it off to sleep to keep promitong blood flow to my pubic area. I also wash with neutral soap and water everyday and change gauze three-four times daily. Will I have a hole there forever?

Gerald Minniti, MD, FACS · Answer

Hello,Those sutures are just going to erode through your skin long before your wound heals. Additionally, wounds don't heal if they are lined with dead tissue, like yours.  You need to find a surgeon who remembers the principles of wound healing. You'll need sharp debridement of your wound until there is no more dead tissue. At that point, you can start normal saline soaked gauze covered with dry gauze (wet to dry dressings), which get changed thrice daily. Peroxide is too caustic for the fragile healing tissues, so you won't need that anymore, nor will you need topical or systemic antibiotics.  Best of luck!

Vishnu Rumalla, MD · Answer

Thanks for your inquiry, most abdominal wounds heal with proper woundcare and time.  You are doing the right things and seeing your plastic surgeon regularly.

Daniel Barrett, MD · Answer

Dear ll67h,this is not uncommon issue after tummy tuck. Based on your photos and description, it looks like your plastic surgeon has a good plan. I would suggest you to follow his instructions. Your wound should eventually heal. Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Robert J. Spies, MD · Answer

First and foremost, do not worry!  This will heal either on its own with wound care or with a small procedure to stitch together.This problem does occur although not that common.  Treatment varies amongst plastic surgeons.  Based on your pictures, I would remove those stitches so that the open wound could be treated more thoroughly.  Other than that, I agree with your physician.Dr Spies

Curtis Wong, MD · Answer

and the sutures placed to diminish the size of the hole is not helping.  The dead tissue has to be cleared completely before healing will start and if there is any odor, your wound needs to be debrided more than just approximated as it is now.  Your final scar will be much smaller than what the hole looks like but excellent wound care is needed to get this to heal asap.  Is your surgeon a plastic surgeon or a cosmetic surgeon?

Steven Turkeltaub, MD · Answer

Ultimately, this hole will heal. Treated properly and without infection occurring it should heal quicker. The peroxide may delay wound healing. Furthermore,  the wound may be better addressed with the sutures removed. Not  knowing your history and without a close examination, you need to follow your surgeon's recommendations.Steven Turkeltaub, MD

Anthony J. Taglienti, MD · Answer

Thank you for your question. No, you should not have a hole there forever. I am not certain why you have stitching in that area - unless your PS tried to close it, and the hole simply opened up again. In some patients after a tummy tuck, especially if they are or have a history of smoking or prior abdominal surgeries, there can be some wound healing difficulties (also made worse if the patient is diabetic). In cases like these, there are a variety of options. Keeping the area clean is the most important, but depending on the depth of the wound, some surgeons advocate packing it. Without examining you in person, chances are what your PS is recommending is adequate for you to heal. It is important to know that this does take some time - and for most patients, it can take anywhere from 2-8 weeks for wound like this to heal depending on the size, depth and wound care regimen. I would suggest increasing your protein intake to help promote healing, and to keep in close contact with your Plastic Surgeon. Best of luck!

Eric Fynn-Thompson, MD · Answer

Having a significant wound can definitely be alarming especially after a cosmetic procedure but rest assured that with simple wound care it should go on to heal well. It might possibly require a revision surgery in the future. I would also remove the sutures as they are not holding anything together,allowing you to clean the deeper portions of the wound better. Sometimes I tell patients to use a saline gauze dressing that is damp and then dries to help clean up the wound from the inside. Good luck.

Tom J. Pousti, MD · Answer

Congratulations on having undergone the tummy tuck procedure. These types of incision line healing problems are not uncommonly encountered after tummy tuck surgery.   Generally, these types of incision line healing problems are self-limited and heal over the course of a few weeks.   Sometimes the area may look worse, before it looks better, usually by the two month post mark.  Sometimes, removal of unhealthy tissue and/or exposed sutures may help expedite the healing process. 
Wound care regimens will differ from one plastic surgeon to another. Generally, this will involve application of some type of sterile dressing ( in my practice I use a non-stick dressing covered by a sterile dressing). You should have peace of mind that these types of wound healing problems generally go on to heal over the course of the next several weeks, often without long-term sequelae. Also important to concentrate on a healthy diet, including good protein source.  Best wishes.

Franco R. Jacome, MD - Account Suspended · Answer

Thank you for your question and pictures. You will not stay with a hole forever. That wound will heal but it will take time. It is very important to follow your surgeons instructions and to have patience since it will be a slow process but eventually it will heal fine. Good luck

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