Wound dehiscence, what should I do? (photos)

Question

26 days post op. I was cleaning my incision When It opened! Now with serosanguinous to bright red bloody. It has been increasing the last few days before it opened. I have been taking showers, using soap and water.

Brian K. Reedy, MD · Answer

Thank you for your recent photos! I would recommend you contact your surgeon to get this wound taken care of right away. Best of luck!

Steven J. Rottman, MD, FACS · Answer

Thank you for your question and photographs. I am sorry to hear of your wound healing problems. You should be seen this week by your plastic surgeon for specific wound care instructions. Hope this helps and good luck.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  The first step would be to reach out to your surgeon's office so that they can recommend local wound care to ensure that you go on to heal without further issue.  It will take several weeks, but your body will have to heal this from the inside-out, typically with the use of daily dressing changes.  Your surgeon will be able to give you the best recommendation.  Hope this helps.

Darryl J. Blinski, MD · Answer

See your operative surgeon ASAP!OH bet you were out of country patient! Than pre pay for local care, this could cost you a few $$$$.

Giovanna Ghafoori, MD · Answer

Hi, RStubb.Wound dehiscence is not an uncommon complication following a tummy tuck.  Most often, especially if managed well, the final outcome is not affected or is minimally affected.The dehiscence occurs when there is an area that does not have adequate circulation.  The yellowish-white, cheesy tissue present in your photos is fibrin, and basically represents a layer of dead tissue. The fibrin and other necrotic tissue will need to come out (your body is already trying to take care of that; wound care and dressings, usually packing, will take care of the rest; sometimes surgical debridement is needed).  Then your body will begin to heal from the inside-out, filling in the cavity with a pink tissue.  As the healing process proceeds, the wound will begin to contract and get smaller and smaller.  Often times, the final scar is only minimally thicker/bigger in this area.  Sometimes, the wound edges may begin to roll, or the top is healing faster than the bottom, and a dimple can form instead -- this is usually easily corrected with excision of the dimple and recluse down the line.The frustrating part of a wound dehiscence, is that beside being unsightly and sometimes odorous, it is fairly slow to heal.  But with good wound care and close follow-up with your surgeon, you will see steady and positive progress.Best of luck! And heal rapidly :)

Tom J. Pousti, MD · Answer

I am sorry to hear about the complication you are experiencing. Superficial separation of the incision line is a known complication after tummy tuck surgery. Close follow up with your plastic surgeon will be in your best interests; sometimes removal of a exposed suture and/or removal of any unhealthy tissue will expedite healing. Otherwise, wound care regimens will differ from one plastic surgeon to another. Generally, this will involve application of some type of sterile dressing ( in my practice I use a non-stick dressing covered by a sterile dressing). 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 (2-4) weeks,  without long-term sequelae. Also important to concentrate on a healthy diet, including good protein source. Occasionally, in the event of a wider scar, scar revision surgery may be helpful down the line. Best wishes.

Jason M. Petrungaro, MD, FACS · Answer

Thank you for your question.  I am sorry that you're experiencing this.  However, this is a very manageable complication.  The most important thing to do is make sure your Plastic Surgeon is aware of what is happening.  He or she will most certainly have very specific instructions for your wound care.  It is also important that they see it in person to make sure no infection is setting in -- if so you may need some antibiotics.My advice when something like this happens is frequent showers with antibacterial soap followed by dressings consisting of some antibiotic ointment and gauze.  Your body will heal this from the inside out, so don't worry.  It will be a mild inconvenience for a few weeks, but be vigilant about your wound care and things should end up just fine.  And once healed, the scar will likely not be much of an issue either, especially since it is below the pant line.  Best of luck to you!

Ven Erella, MD · Answer

Thank you for your question. I am sorry this happened to you. It can happen sometimes after TT. Most likely it is going to heal fine. You need local wound care as per your PS.

Lawrence Bundrick, MD (retired) · Answer

You need to schedule an appointment and follow up with your surgeon as soon as possible so that he/she can get you on a wound treatment plan.

Alan M. Engler, MD, FACS (retired) · Answer

While unpleasant, a wound dehiscence of the degree indicated in your photos happens periodically and can normally be managed conservatively - and your result will be essentially the same as if it didn't happen.You should of course discuss this with your own PS and expect to be seen in person to confirm whatever you talk about.Your treatment thus far is about right - showers, dressings, etc, and allowing it to heal on its own.  More aggressive treatment should not be necessary as long as the fluid output slows.  It's not uncommon for there to be a little at first and then more, as some fluid trapped inside is released.  This, again, should be confirmed and your entire recovery supervised by your PS.I hope that this helps and good luck,Dr. Alan EnglerMember of #RealSelf500

Wound dehiscence, what should I do? (photos)

Answers (10)