Tummy tuck in Jan developed a dehiscience with a tunnel next to it which is not healing. What are my options? (Photo)

It is not that uncommon to have small openings in the scar line after a tummy tuck procedure.  But, they generally heal by themselves within a few weeks or a month.  Your wound is several months old and is not healing apparently.  I agree with your surgeon that is is probably related to permanent suture material in the wound.  It is not because the layers were not approximated. At this point you need to have the entire area excised,  incorporating the skin opening, the entire tunnel and some normal tissue on all sides.  At the deep point of the wound I am sure there will be suture material that is the cause of the problem and this will need to be removed. This can easily be done under local anesthesia alone or very mild sedation if you are nervous. You will feel and look so much better soon after that small revision.  Good luck!Thomas Taylor, MDPasadena, CA

The tunnel needs to be healed.  If the surgeon thinks there is a permanent stitch preventing the healing, then that needs to be removed upon exploration. After that surgery, the wound needs to be closed, or left open to granulate.  This can be accomplished with a wound VAC, or by opening the wound so that it is not a tunnel but a trough.  The wound care "specialist"  has absolutely no idea at all what they are talking about with respect to approximation of layers.  They have probably never even seen a tummy tuck.  This is not from a failure to approximate layers.  The plastic surgeon could have performed a tummy tuck using the utmost care and meticulous technique, and still this could have occurred.  Wound healing issues after tummy tuck occur, but not based on negligence.  This just needs to be dealt with.  The surgeon is the right person to take care of this.  I would not even have ever involved a wound care "specialist" and I would suggest that they are replaced by a plastic surgeon immediately.  

This is likely a retained permanent suture acting as a foreign body. Given your history, the wound will likely not close until that foreign body is removed. The surgeon you are seeing will likely recommend wound exploration, removal of the suture and wound closure. It is a good idea to have your local surgeon speak with your operating surgeon.

Sometimes a wound can extend to the deeper layers no matter how careful the closure.  Options at this time may include continued conservative care allowing it to heal from deep to superficial but this may take some time.  Another option would be to remove the affected area and resuture it to get it to heal.  I would advise seeing an experienced plastic surgeon to deal with the issue. 

Open wounds can happen even if you "close all the layers."  It sounds like your wound needs exploration and re-closure. You should seek expert advice in your home state since you will need continued follow up. It is a long journey but hang in there!Best wishes. 

I am sorry to hear about your problem. At this point the safest next step is a revision that can likely be done under local anesthesia. I would contact your original surgeon first and check with him/her on how to proceed.