Unhealed necrosis at Tummy Tuck incision. Is it going to continue to get larger? (photo)

I am now 4 weeks post op and what started as a small hematoma at my TT incision line has now turned into a 2 inch by 1inch necrotic wound. I have been using silvadene since the first sign of broken skin, but the wound just continues to get larger . I now can see a hole tunneling and stitches showing. I don't know what else to do to fix this problem. I clean the area twice daily as well as keep it covered at all times. Is it going to continue to get larger?

Doctor Answers 11

Dr. Kimberly Henry

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Hello and thank you for your question! By your pictures, you appear to have excellent granulation tissue; so, your wound should eventually get smaller and smaller, just be patient and keep doing what you are doing with wound care. And follow up with your surgeon regularly. Best of luck!

Greenbrae Plastic Surgeon

Tissue necrosis wound will heal

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The photos you submitted are good and show normal healing progress. Small areas of wound separation and tissue necrosis are fairly common and are in the middle of the incision most often. Most heal well with local care, like you have been doing. They often look worse before they shrink in size and close completely. Patients are usually surprised how normal scars look after six months. Some of these healed wounds will need a scar revision, but many do not.

Keep taking good care of the area and follow up with your surgeon on a regular basis. Hang in there because it will get better.

Michael S. Hopkins, MD (retired)
Albuquerque Plastic Surgeon

Healing will take time

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but it will heal and the scar will be smaller then what you are imagining. Your results look great and when this is healed, then you and your surgeon can decide together if a revision will make a positive change in your outcome. Continue with your wound care and your surgeon will follow you through this journey.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Area looks about the size that I would expect

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Dear FNP,

Thank you for the great photos. The area that you have shown is about what I would expect from the amount of necrosis that you have shown initially. It appears clean and with good healing tissue. I think you will be fine and the wound will heal well on its own. Your plastic surgeon will be a great resource during this process to answer questions in terms of what to expect.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Skin loss after tummy tuck

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Take a deep breath, I believe you will have a fantastic result in the long run. This is an inconvienent problem, but will heal. Many times what you feel is helping, may be hurting wound healing. No peroxide, just soap and water. Bacitracin or neosporin to the would will help the healing. The bloood supply at the edges of a tummy tuck can sometimes be poor, it is the blood supply that heals the wound. Over the next few weeks blood supply will improve and the wound will close. Right now I can see in the photos healthy granulation tissue which means healing is progressing. Once healed, if the scar is a little thick in this area, your surgeon can do a scar revision and that should be the end of it

Eric Weiss MD

Eric Weiss, MD, FACS
Orange Park Plastic Surgeon
4.9 out of 5 stars 34 reviews

Wound after Tummy Tuck Surgery?

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Although the type of wound healing problem that you are experiencing can be frustrating, you should have peace of mind that this area will go on to heal over the course of the next few weeks. Sometimes, at four weeks postoperatively, the area can look "worse before it looks better".

I do not believe that there is any "magic formula" that will expedite the wound healing. This is one of the issues that simply requires time and patience.

Continue to follow up with your plastic surgeon. With the exception of the potential need for scar revision of the area, you should have a very nice outcome in the long term.

Best wishes.

Skin lost after a tummy tuck

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The area of your skin lost is the area that is furthest away from the blood supply of the skin after a tummy tuck. It is also the area that has the most skin tension. Continue your present treatment and the area should continue to heal. The final scar will shrink over time and can be revised if necessary.

Michelle Hardaway, MD
Farmington Plastic Surgeon
4.8 out of 5 stars 130 reviews

Tissue necrosis

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Uncommon and unfortunate, tissue necrosis generally heals on its own. It may need some surgical debridement by your plastic surgeon (although it does not appear to need any now). Best of luck.

Tummy tuck wound

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Dear FNP,

Silvadine is a good choice for the wound that you have photographed. It appears that you have been doing a great job with your dressing changes as there is good granulation tissue (beefy red tissue at the base of the wound) in the later photos. It will start to heal quickly now that the granulation tissue is present. Once it's completely healed and some time has passed it can be revised if need be with likely a nice outcome. Close follow up with your plastic surgeon is key so he/she can evaluate your progress.

Healing of Tummy Tuck Wound Necrosis

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When tissue necrosis occurs along an incision line, it takes four to six weeks for the wound to evolve and die back to healthy tissue. Thus it always gets worse before it gets better. Then granulation tissue will develop in the depth of the wound which will gradually fill it up and slowly begin to close it down. Once it reaches this point it will move more rapidly towards eventual complete healing. This is a process that will likely take a full 3 months to complete. The use of Silvadene is the best thing to do and make sure you freely put a lot into the wound twice a day. While at some point when the wound is a lot healthier, closure can be done but most patients at that point usually let it complete its natural healing process for fear of causing the exact same problem.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.