I am six weeks post op and my belly button is seeping dark, smelly fluid. I have a 2 inch opening at the scar that is taking a long time to heal even though I maintain it with clean gauze. Today I went in and told him that I felt that there was a lot of fluid retention. When he checked a large amount of puss was extracted. He sent this away for a culture. My doctor didn't use drains because he used a suture method to prevent fluid build up. I am now worried that this caused an infection.
Answer: Infected Psuedo Bursa, Needs to be re-openned and excised. Permanent sutures need to be excised as well. Thank you for your post. Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak. The whole point of drains is to keep a seroma from happening in the first place. If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent. If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening. If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat. An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel. Occasionally, a seroma can also become infected, especially if a permanent braided suture was used. This will have a hot, red appearance, and will eventually open up. I have never seen an infection from sterile aspiration of fluid.Best wishes,Pablo Prichard, MD
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Answer: Infected Psuedo Bursa, Needs to be re-openned and excised. Permanent sutures need to be excised as well. Thank you for your post. Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak. The whole point of drains is to keep a seroma from happening in the first place. If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent. If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening. If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat. An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel. Occasionally, a seroma can also become infected, especially if a permanent braided suture was used. This will have a hot, red appearance, and will eventually open up. I have never seen an infection from sterile aspiration of fluid.Best wishes,Pablo Prichard, MD
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February 23, 2011
Answer: Abscess After Tummy Tuck. How is This Treated?
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February 23, 2011
Answer: Abscess After Tummy Tuck. How is This Treated?
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