How to Treat a Hematoma That is Now Infected?

If it is felt you are still bleeding then the bleeding needs to be stopped by reoperating. If it’s old liquified blood which would be brownish and it is felt to be old blood, a drain can be placed through the incision to allow the space to close in. It’s a special drain called a penrose and will allow the fluid to drain while the space closes up. This is a simple way to deal with this and works well especially if the space is is infected. Actually the infection will help the space close but only if it is properly drained.

Thanks for the question and sorry you have had so many problems. YOur PS is doign all the right things. Unfotunately this can sometimes happen. You have been unlucky, bu tht emain thing is that your PS is doign the right thing to treat the area. WIth infected haematomas - it is a case of opening the area up and letting it drain - it might mean leaving the wound open and letting it drain and allowing it to heal by what is called secondary intention. YOu may well have the drainage and a VACuum based dressing placed on the area. This will help to suck out any haematoma. HOwever, prior to applying  this, the area will need to be washed out. You will also be on a course of antibiotics afterwards. Once this area has totally healed, you might well be left with widened scars which might need a revision. So I would be prepared for a longer post operative recovery in your case. Again, it is unlucky and unfortunate but your PS is doing all the right things. He will be as upset as you are with the results currently. I hope this is of help to youBW

Unfortunately, bleeding and hematoma formation can occur when
patients undergo abdominoplasty surgery.When this situation arises it’s appropriate to drain the hematoma and
place drains.When hematomas are drained,
blood that has infiltrated the soft tissue is always left behind and sometimes
can become infected.Under these
circumstances, re-operative surgery is usually always necessary to remove
residual blood and infected tissue.Once
infected, blood acts as an excellent culture media and without removal can lead
to septic complications.For this
reason, it’s appropriate for your surgeon to treat this problem as soon as
possible.

It sounds like an evacuation procedure will allow this to heal correctly. Your PS will remove all the old blood and scar tissue. These things happen, you are just one of the unlucky patients with a complication.

    Hematoma after tummy tuck probably occurs 1% of cases, and infection after this is possible.  I hope that you are now healing well and infection free.

I am sorry to hear about the trouble that you are going through.  Plastic surgeons are doctors first and foremost and our intention is always to help our patients and do what is best for them.  Sometimes when faced with a problem the best thing to do is to go back to the operating room and correct it.  Delaying surgery can sometimes make the problem worse.  If you are ever in doubt about what your doctor is telling you then getting a second opinion from a respected board-certified plastic surgeon in your area may provide you with peace of mind.  Best of luck.

It is not normal to continue bleeding for a week after a tummy tuck.  If you developed a hematoma after your surgery and it was big enough, then it was correct for your surgeon to drain it in the operating room.  If you continued to bleed even after your second surgery, that blood can become infected.  If this happened it is absolutely necessary that the blood and infection is removed (debrided) and washed out with sterile fluids.  Drains must also be placed to allow the blood and infection to get out of the tummy tuck site.  If you do not get this taken care of, you can develop systemic blood infection (known as sepsis) which can be life-threatening.  You should certainly be on antibiotics at this time.  If you are STILL bleeding then you need to talk with your surgeon and determine if you have a bleeding disorder.  You may need to see a hematologist and get some tests done.

I am sorry that you have had this problems.Your PS is right on target. draining hematomas that are infected is the best way to control the complication. Although is seems excessive, it is the most expeditious way to control the problem and bring you back to the adequate course.Be patient. Hopefully this is just a temporary thing.Best of luckJulio Clavijo-Alvarez

Sorry hear about your ordeal. Contaminated collections of blood and fluid will usually not be adequately treated by antibiotics alone, and the advice for an operative approach sounds correct. All the best. 

 I am so sorry to hear about your adverse events. Yes, it is mandatory for an infected hematoma to be drained/ cared for by surgery. Failure to so can be disastrous.
 Two questions do come to mind that you may want to ask your surgeon. First, do you have a BLEEDING DISORDER that makes you prone to beed. Second, WHAT BACTERIA or FUNGUS is causing this infection.
 Remember that you and your surgeon need to work together to get you over these adverse events. Smoking/ Secondary Smoking, taking medication that can make you bleed ( Alka Seltzer), not following recommendations, etc. will only prolong your agony. If you have lost faith in your surgeon consider another but, few surgeons/ contractors like to clean up a mess that someone else has created. With a high incidence of future medical-legal actions, lack of funds/ insurance coverage for adverse events, etc. it is often a Lose/ Lose situation for another surgeon.
  This is why it is always good to consider a cosmetic surgeon that provides Cosmetic Surgery Insurance like Cosmetic Assure or Cosmetic Protect as part of you package price for surgery. These companies provide insurance  coverage for most adverse events after aesthetic surgery. We provide this service/ coverage for all our cosmetic surgery patients just in case unpredictable untoward events occur in the post operative period. I hope things work out for you. Best,

 

 

Gary R Culbertson, MD, FACS