Is It Common for Permanent Abdominoplasty Sutures to Get Infected After 5 Years?

Your situation is quite unusual, but not unheard of.  My thoughts on this would be:

1) to consider a consultation with an Infectious Disease physician, so as to determine the most appropriate antibiotic treatment regimen for you.  

2) Since your situation is unusual, it might be wise to have a CT scan of the abdomen to make sure there isn't anything else going on - abscess, fistula, hernia, etc.

3) Since it can be difficult for the body to clear an infection around a foreign material, you may require surgery to remove the offending sutures, and wash out the area.  These can be very challenging.

Best wishes, 

This is not common but it does occur. The alternative would be to perform muscle repair with non-permanent sutures but we have found this to be less succcessful than the use of permanent sutures.

The type of problem you're having with sutures is rare at the five-year post-op mark (but not unheard of). I have had a few patients who have had problems with Ethibond  sutures and have required every one of these sutures had to be removed before they healed. If you find that you do have continued problems with drainage (for example from the incision line or umbilicus) I would not be surprised if the underlying sutures (and a resulting fistula)  are to blame.

Treatment would involve removal of all the sutures, washing out of the abdominal wall thoroughly, replication  with a non-braided  suture if necessary and closure over drains.

Best wishes.

In our practice, we find that as every patient is unique so is every tummy tuck. We spent a great deal of time preoperatively talking to patients and understanding their concerns, their goals, and evaluating their body anatomical tissue. This allows us to create a surgical plan that will meet their concerns and help accomplish their aesthetic goals. In the patients that require muscle tightening we do perform a muscle repair with permanent suture. The suture is placed in a manner that is below the covering of the muscles and will not be noticed by the patient. Typically, the sutures to perform their role and are not culpable or noticed by the patient. Although it is very uncommon for the sutures to become infected, everything is possible in life and surgery. If you notice redness, a firm area, swelling, or a collection underneath your skin, your best bet is to work with a plastic surgeon who is board-certified by the American Board of Plastic Surgery and has extensive experience with abdominal surgery and body contouring. They will be able to carefully evaluate you, determine what is the cause of the swelling and formulate a surgical plan to correct this issue and maintain a great aesthetic result for you.

While not common, it does happen with certain permanent sutures that are sometimes used for abdominoplasties, hernia repairs and other abdominal surgeries. Suture made from braided nylon (Ethibond) seems to be the culprit in most cases. Unfortunately, these problems can arise years after the original surgery. Sometimes they can be dealt with during an office procedure if only one small area is involved. If it continues to be a recurring problem, a surgical procedure may be done to remove the offending sutures (without undoing your abdominoplasty). You may wish to discuss this with your plastic surgeon.

This is a very uncommon problem that can occur.  It is even more unusual for this to occur after 5 years.   Typically there will be an inciting event such as a recent surgery, trauma, or skin infection.  

It is something that may require a repeat surgery to remove all permanent sutures if it does not respond and resolve to antbiotic therapy.   I wish you a safe recovery.

Paul S. Gill, M.D.

Gill Plastic Surgery

Houston Double Board Certified Plastic Surgeon

Regarding: "Is It Common for Permanent Abdominoplasty Sutures to Get Infected After 5 Years?
My stomach muscles started hurting approximately 5 years post abdominoplasty. Went to dr, he said I had a hernia at an old gallbladder incision sent me to surgeon. Surgeon took me into surgery and said I didn't have hernia and cleaned up scar tissue. Muscles continued to hurt. Year later started draining pus, surgeon went back in and found permanent tummy tuck sutures infected. Cleaned it up and 3 months later I drained pus again and my stomach muscles continue to hurt. Is this common"

In my personal experience with hundreds of Tummy Tucks (using permanent stitches), I have never encountered a problem such as yours.  While it is plausible, it is extremely rare.

I am somewhat bothered by the way your management appears to have been handled. A doctor (?PCP) thinks you have a hernia at an "old gall bladder incision" (I assume it was an old fashion scar along the lower edge of the right ribs NOT a series of three button long scars). You see a surgeon. NO CT or MRI is done which MAY have picked up the reason for the pain without surgery. You are taken to the OR by the general surgeon who opens up a scasr (? gallbladder surgery VS Tummy tuck operation) and "cleans up" scar tissue which is sure to come back. (?were bacterial and fungal cultures of the scar tissue obtain to confirm pre-presence of infection?). There is no resolution of the pain and  it takes a year for fluid to start draining from the incision (?which one). The same surgeon goes in into the Tummy Tuck and removes a few infected permanent Tummy Tuck stitches. Even though the stitches were removed, the fluid drainage continues.

As surgeons we know that if a source of infection is removed in a personal with normal immunity, the infection goes away. From your diagnosis, it sounds as if the original diagnosis was incorrect. The first operation was either incorrect or insufficient and may have led to the second look-see operation which in itself failed to resolve the issue.

I would recommend you see the Plastic surgeon who operated on you. The vast majority of Plastic surgeons trained fully in General Surgery and should be able to tell you IF they can fix this or refer you to a surgeon who can.

Dr. Peter Aldea

It is very possible that with permanent sutures placed for the plication that they can become infected and require removal.  It is not common.

It would be extremely unusual to develop infection in permanent muscle plication sutures five years following your abdominoplasty.  A more likely scenario is that the infection occurred following your second surgery.  Once the sutures become infected for whatever reason, they need to be removed.  This far out from your tummy tuck, it is unlikely to cause a recurrence of the muscle separation.

It is rare but possible for you to have long term infection in the sutures for your tummy tuck if they were a permanent type and braided material.  That is one of the reasons I don't use these but rather I use heavy duty non-braided dissolvable ones that last long enough for you to heal fully then disappear.