Is it healing at 19 days post op tummy tuck? (Photos)

Question

Using Santyl on open wound. My PS debrided the opening on po day 14. I have been using Santyl and wet dry dressing. It keeps getting bigger. Please any advice on what to do? Is it healing? Why is it yellow and green?

Robert M. Tornambe, MD · Answer

MyTime18.   So sorry you are going through this. It appears from your photographs that you are experiencing wound healing issues after your tummy tuck, which can occur. The wound care medicine Santyl is an excellent enzymatic debriding agent that will clean up your wound without further surgery. Once all the dead tissue is removed by this effective wound care regimen, your wounds will heal uneventfully. It appears that your plastic surgeon is treating you appropriately and well and I would continue followup. Good luck.

Daniel Barrett, MD · Answer

Dear Mytime18,this type of wound is not uncommon after tummy tuck. It is usually caused by poor blood flow. The tissue you are mentioning (yellow and green), is not vital and should be removed. 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

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

I'm sorry you are having issues with your incisions after surgery.  I encourage you to continue to closely follow your surgeon's instructions for wound care.  It can be frustrating as these wounds take some time to completely heal but your surgeon should continue to evaluate your progress and make changes as necessary.

Liana M. Lugo, MD · Answer

Hi there! Thank you for your question and for the pictures. This type of wound is not uncommon after tummy tuck. You have wound dehiscence and with proper care it will heal well. Santyl will help with debridement of tissue. However go back to see your PS, he or she could debride some more in the office. It can take weeks for this type of wound to heal, be patient. I hope this helps and best wishes!

John W. Menard, MD · Answer

We would recommend excision of the necrotic tissue with consideration of closure. I would see your surgeon regarding that possibility.  Good luck.

Thomas Trey Sands, MD · Answer

Thank you for your question. I’m sorry you are having healing issues after your surgery. Most of the time, these wounds look worse before they start looking better. All of the yellow and white tissue that is not healthy has to be removed from other mechanically by surgical debridement or more slowly with chemical debridement (santyl) and dressing changes. It takes a considerable amount of time to remove the dead tissue until you get a base of healthy red tissue. One the red, bleeding tissue is at the base of the wound, you will begin to quickly see the size decrease. The smell, drainage and color is typically produced by bacteria sitting on top of the wound. This doesn’t usually cause systemic infection but should be treated as it slows the resolution of the wound healing. I would recommend you wound to be cultured and then a short course of antibiotics tailored to the wound culture that can help lower the bacterial load as you continue the wound debridement and dressing changes. It is not unusual for these wound to take up to 8 weeks to completely heal so be patient and make sure you have frequent follow up with your plastic surgeon so that they can monitor, debride, culture and change the management as needed.

Marcus Davis, MBBS, MRM, FRCSEd (Plast) · Answer

Dear Mytime18,
Congratulations on your recent tummy tuck and i am sorry that you have experienced this slight setback - this will only be temporary,
What you are seeing in the pictures you have kindly posted is that, as you state, the wound has dehisced - this is not altogether uncommon. The "yellowy-green" tissues that you can see in the wound is a combination of fat that is dead and fibrin - tissue that your body produces as part of the healing process.
Your body will heal itself and is being helped by the dressings your Plastic Surgeon has advised you to be using. Stay in regular contact with your Plastic surgeon and in weeks/months to come you will I suspect forget you even had this small setback.
I wish you luck.
Marcus

Daniel Greenwald, MD (in memoriam) · Answer

This is an unfortunate complication of surgery that will go on to heal uneventfully over a a month or two or three.  The skin and some of the deeper tissue did not survive the operation due to tension on the wound and stress on the blood supply.  This is not uncommon and is not the sign of anything to worry about: it WILL heal and you will have a nice result.  You may or may not need a minor scar revision at that site when all is mature.  For now the care is just dressing changes and time.  Some surgeons debride the dead tissue in the office to aid the healing process, something the Santyl will do enzymatically,

Is it healing at 19 days post op tummy tuck? (Photos)

Answers (8)

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