What should I do for extreme pain & swelling 3 1/2 mos post op & what does irregularity in the rectus muscles mean? (Photo)

Question

3 1/2 mos post op ETT & abd is still swollen &hurts. CT scan done stated: some irregularity in the rectus muscles of my abd & some extra fluid in the lower abdomen & around the incision. It is thought this is all related to your surgery however these shouldn't be present 3 months out.There was no evidence of overt infection or abscess.My PS w/o seeing me dx a seroma. What does irregularity in the rectus muscle mean? Over incision is hard on both sides, like bone. Looks like keloids & dog ears

Robert M. Lowen, MD · Answer

If there is fluid, that is by definition a seroma, and would be treated by aspiration or  replacent of a drain like a Seromacath,  which is a small percutaneous drain which is easy to insert in the office, with or without ultrasound guidance.
  Scar hardness at the sides is common for the first three months and should soften over the next few months at which time a revision can be done if  needed. Scars that are thick and raised are called hypertrophic, and keloids are a scar mass that extends beyond the scar border.
  Treatment of hypertrophic scars is by siicone pads, like Embrace, scar gels like Biocorneum and lasers, such as fractional erbium or short pulse 1064 YAG (aerolase) or similar.

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