Should I go to e.r for antibiotics? My dr says I’m fine. But I don’t want to get MRSA? (photos)

Question

My wound is getting worst by the day. I’ve been self treating it myself as sterile as possible and using neosporin. My dr is not seeing by the week and tells me it’s fine. I don’t want to wait till it gets any worse then this to get treatment.

Gerald Minniti, MD, FACS · Answer

Hello,If your surgeon is aware of this wound breakdown and put tape over it, you need to find another surgeon. No one in an ER, except maybe a plastic surgery consultant that is called in, would touch this. They might give you antibiotics, but that won't help.  You need a competent surgeon to remove the dead tissue, and get you started on dressings that will optimize healing and wound closure. Go visit a few ABPS certified/ASAPS member surgeons who specialize in body contouring.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. This is not an issue of infection but rather an issue of skin necrosis (death) from poor blood supply. There is no question that this needs to be seen as soon as possible and treated by your plastic surgeon. If he or she is not hearing your concerns and addressing them, then I assume you did not choose a plastic surgeon who is board certified by the American Board of Plastic Surgery and I suggest you find one ASAP.Good luck!

Daniel Barrett, MD · Answer

Dear M.Jackson,this type of wound is not uncommon after tummy tuck. It is usually caused by poor blood flow. I would suggest you to consult your plastic surgeon, follow your surgeon's instructions and keep your wound clean and covered. It can take few weeks or months for wound to fully heal. Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Curtis Wong, MD · Answer

as you have flap edge necrosis and its is demarcating to where office debridement will remove the dead tissue and help facilitate secondary healing by your body.  Your wound is clearly contaminated and colonized with bacteria but open wound rarely lead to systemic issues.  If you were my patient, you would be seen weekly to remove the dead tissue as much as possible and wound care instructions would be provided.  Antibiotics are not required unless you develop signs of cellulitis.

Steven Turkeltaub, MD · Answer

Sorry that you are having this wound healing problem and are quite stressed about it. This type of issue is not a rare phenomenon with tummy tucks and is related to locally inadequate blood supply issue. Fortunately, this well heal with time - from a few weeks to a month or so depending on a variety of issues including the appropriateness of local wound care.You should discuss with your surgeon how to take care of this appropriately. If he/she is NOT a plastic surgeon then you may want to consider seeing one in order to maximize the healing potential and minimize risks.Steven Turkeltaub, MD

Tom J. Pousti, MD · Answer

I'm sorry to hear/see the complication you are experiencing.  My best advice: reach out to your plastic surgeon again and request in-person evaluation. Your plastic surgeon and staff will have the expertise necessary to help you with wound care  and with decision-making regarding the need for antibiotics. This expertise (with all due respect to the emergency room physicians and staff) will likely not be available in the emergency room environment.  Again, with all due respect, the emergency room environment may be an enviornment "filled with" all types of antibiotic resistant bacteria. Wound care regimens will differ from one plastic surgeon to another. Generally, this will involve application of some type of sterile dressing. Sometimes removal of a exposed suture and/or removal of any unhealthy tissue will expedite healing.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 also want to see you worked down products sequelae. Also important to concentrate on a healthy diet, including good protein source.  Best wishes.

Should I go to e.r for antibiotics? My dr says I’m fine. But I don’t want to get MRSA? (photos)

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