What else can I do to heal? 4 surgeries in 7 weeks. Tummy tuck necrosis and tunneling wound (Photo)

Stop attempting to close it. Let the wound heal from the inside out and revise the scar in 3 months. Continually attempting to close it is not working as the blood supply has not had time to return to normal to the area from the first surgery yet. Hang in there. Your surgeon needs to look you in the eyes and tell you no more surgery for now even though your really anxious about it and everything will be fine in the end.....it will!Best

Hello Aimers,Great question. Thank you for your pictures. I am sorry for your difficulties in recovery. However, it seems your surgeon is doing everything necessary to help you recover. Follow his post op instructions as he is the one who is closely monitoring your recovery. Best of luck with your recovery.

Sorry to hear about your problemsthis is a real shame and your surgeon is obviously doing their best for you. I think now it is clear the blood supply to your tummy skin is compromised and letting everything heal from inside out is best. This will still take some weeks so please be patient. Using the VAC would also be appropriateScar revision 6-12 months down the line can then take placeGood luckPaul Banwell (London)

Hello and thank you for the question and sharing your photos. Your lower abdominal skin is likely ischemic (not getting enough blood supply) and that's why your wounds keep opening up (you need good blood supply to heal wounds).  These wounds should be allowed to heal spontaneously from the bottom up. Once completely healed, then your surgeon can do a scar revision to improve the appearance. I would wait at least 6 months after completion of healing prior to making any attempt at revising the scar. Best,

Sorry to hear about your experience. It seems that the blood flow to the central abdomen is fairly compromised and each advancement puts tension on the flap and causes further necrosis. At this point my suggestion would be to get the wound to heal secondarily and perform a scar revision after 6-12 months. I would personally suggest the use of negative pressure wound therapy (a VAC) and/or adding hyperbaric oxygen treatments. Ultimately without examining you it’s difficult to be 100% sure what the underlying issue is so you’ll need to trust your surgeons advice. You can always get a second opinion if you are concerned the complication has gotten away from your PS. Best of luck! 

you need to allow more time for your wounds to heal. As long as you are not smoking and following instructions they should heal. You may need a scar revision once the scars have matured in a year or so 

I'm sorry that you are experiencing so many complications since your surgery.  It is good that you are in close contact with your surgeon and strictly following advice.  It appears that your wounds are caused from a lack of good blood supply to the tissues.  Unfortunately these wounds take some time to fully heal.  You may want to work with a wound care specialist along with your surgeon if improvement isn't seen.

Hello and thank you for your question and photo's.  Sorry to hear you're going thru healing issues, it is a process but it will heal in time albeit not something you want to hear.  It sounds like your PS is doing the right thing seeing you every week and debriding when necessary and basic wound care.

Good afternoon, Almers123.  Thank you for sharing your photos and your concerns.  I am sorry that you are going through this difficult complication following your TT.  In looking at the sequence that you provided, it appears that the ischemia (lack of circulation) continues into the skin's fatty tissues, resulting in more tissue death with each subsequent closure.  Unfortunately, this process is not likely to stop, particularly given your progression to date.While it is not what you would like to hear, most likely what you would need for healing is debridement (removal) of any remaining and new non-viable tissue, and leaving the wound to heal open.  This approach will give the circulation a better chance to recover and will minimize secondary compromise to the circulation due to tension.  It will also help reduce the risk of infection by allowing the wound to optimally drain.  This is a slooooow and inconvenient process, and the wound may (most likely) will temporarily enlarge as the tissue retract back to a less-tensioned position.  However, once all of the non-viable tissue is out and the circulation begins to recover, the body will begin to fill in the defect with pink, velvety tissue called "granulation" and the wound boundaries will begin to contract inwards, making the defect significantly smaller.  A wound V.A.C. can reduce the frequency of dressing changes (to several times a week from multiple daily) and speeds up the granulation/contraction process.  There are a variety of wound care substances that may, or may not, enhance this process -- at the end of the day, any and all good wound care strategies will heal a wound of this type.The resulting scar will be no where as big as the wound was, and may or may not require revision.  However, allowing sufficient time for the circulation to fully recover, the scar to soften, and the tissue to relax is important for an optimal outcome and a minimum risk for recurrent ischemic problems.I can understand that you are devastated by this complication, and I suspect that your surgeon is equally so.  It appears that your surgeon has been doing his/her best to provide you with an expedient satisfactory outcome.  Unfortunately, this has not been met with success and likely will not be successful to be repeated "one last time."  Your surgeon has demonstrated he/she will see you through this.  Best of luck!  Dr. Ghafoori

I'm sorry to hear about the complications you have experienced. Although I understand your concerns, sometimes it is best to do less (allow for wound healing to occur) as opposed to too much intervention. In cases like this, it may be best to allow for ongoing wound healing to occur as opposed to attempts at closing wounds. These attempts are often met with further problems such as infection and/or further separation.  Of course, interventions such as removal of unhealthy tissue and/or expose sutures may help expedite the healing process. Time, patience, good nutrition, and close follow-up with your plastic surgeon will be your best "friends" at this point. Best wishes.