Leaking from Tummy Tuck Scar?

Question

I had my tummy tuck 10 days ago & my doctor removed the drainage the day after surgery, he kept the scar covered for 1week then cleaned it with saline & told me to take a shower &thats it..I kept cleaning the scar with betadine & dressing for 3 days till i noticed theres raw area in the center & little red fluid coming from it, my PS told me to remove the dressing & stop the betadine, and just wash it with normal water and put fucidine or mebo cream on the raw area for 3 days, is that normal?

Luis Suarez, MD · Answer

Hi Jasmine ,
	What is happening to you is normal , what most likely happened is you expelled a suture and you are now expulsing a little liquid. It is normal there is nothing to worry about. But it is always important to go with your surgeon so he can check you out and you can be more at peace. 

	Hope this helps 
	Regards !

Larry S. Nichter, MD, MS, FACS · Answer

Best Scar Management is important to minimize or completely hide from view, the telltale signs of your surgery—namely, scars. Both you and your surgeon want you to have the most minimal scarring possible. There are many possible causes for scars that are enlarged or not healing well. Unsightly scars are most commonly due to genetics, underlying medical conditions, or improper scar/wound care. The last part is very important and patients can make a noticeable difference in their scars’ appearance by following best scar management practices. Here are some simple tips.
Scar Management tips:Minimize tension on the scar. Steri-Strips and/or surgical tape are often placed in non-hair bearing areas at the time of surgery to minimize tension and keep pressure over the scar.  This minimizes the  stress that  can pull the scar apart (dehiscence) creating a wound and  delaying healing time, and can make the scar wider, or more “ropy”. In the first few weeks after surgery, I recommend the use of Embrace Scar Therapy which is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar.Keep your incision site/scar clean to prevent infection. Follow your surgeon’s wound care instructions to the letter with out modification. Never apply different products then recommended without first discussing them with your surgeon. This is especially important during the first few weeks. If there are any signs of infection, contact your surgeon’s office right away and/or see your doctor or his nurse immediately. Typical signs of infection may include redness outside the immediate incision site, asymmetric swelling, and drainage, of pus, fever, chills, and “feeling sick”.Protect your scars from the sun. Staying out of the sun is the best advice. Minimal exposure to sunlight is prevents hyperpigmentation (permanently turning brown) and other problems that can make the scar more noticeable. Sunscreen, at least 30 SPF and an overlying make camouflage make up additionally protects the scar from the suns harmful rays. This advice is especially important the first year following your surgery.Use specific scar maturation products recommended by your surgeon. Patients seem to have their own opinions on this touting everything from Pure Vit E, Coco butter, to Aloe Vera, etc but most have minimal benefit other than keeping the scar hydrated. Although hydration is important there are better, scientifically studied products with greater efficacy. Most of the scientific articles written about this subject indicate that topical silicone gel or silicone sheets work the best. The best product available in my opinion is the Embrace Scar Therapy System by Neodyne BioSciences, Inc. available in many surgeons’ offices. Essentially this is an adherent silicone sheeting pre-stretched when applied so as to offload tension on the scar. For areas that are not applicable for this product (e.g. smaller areas or on the face), I prefer BioCorneum or Kelo-Cote products There are a lot of products to choose from, but silicone should be one of the key ingredients. Although Mederma, an onion extract derivative active ingredient rather than mainly silicone based may help, primarily silicone based products are better and many also contain other ingredients that may be synergistic (hydrocortisone or other steroid, Vitamin E, Sunscreen, etc).. If the reader has problems obtaining these they can call my office. Patient compliance is also critical – use often and according to directions or it will not work optimally. NEVER apply products without first discussing them with your surgeon.Monitor to make sure your scar is progressing optimally. Keep your scheduled follow-up appointments with your surgeon to verify that your scars are maturing as expected.  Occasionally if indicated you may need a topical steroid preparation or even a series of  injections (5-FU and/or Steroids) or laser treatments  to treat or  prevent scar hypertrophy or keloid formation (red raised scars), or other topical medicines to treat post inflammatory hyperpigmentation (brown scars) with prescription creams and possible laser treatments.

Naveen Setty, MD · Answer

Small amounts of fluid coming from incision lines after a tummy tuck is fairly common. Make sure you are seen by your plastic surgeon to ensure that there is not a deeper issue or more significant fluid collection leading to the drainage. Also, sometimes over treatment of scars can lead to breakdown especially in the early healing period. Betadine is toxic to healthy cells as well as bacteria. Good luck with your recovery.

Robert F. Centeno, MD, FACS · Answer

It is normal to have some fluid drainage from your incision post tummy tuck.  It is also possible to do too much!  Straight betadine is quite toxic to healing cells and can slow your healing while killing bacteria.  This is not an accepted use of betadine.  Over-cleaning your wound can also damage the very fragile skin leading to drainage, separation and delayed healing.  My suggestion would be to discuss wound care with your surgeon further and follow his instructions.  All the best.

Aldo Guerra, MD · Answer

Hello Jasmin. Thanks for posting about your concerns. Leakage from a wound can occur normally, but should be evaluated by your surgeon soon to rule out a larger fluid collection under the incision. It doesn't necessarily mean now, but soon. Most often, minor things like a spitting suture or slight wound delay can be the cause as well. Best wishes, Dr. Aldo.

Adrian Knox, MBBS, FRACS · Answer

Hello Jasmin,

	By 10 days I would like to see a sealed and dry wound. But fluid from a wound can mean a lot or not much so you really should be guided by your surgeon and keep in close contact until the area has fully settled

	 

	Best wishes

Gavin Sandercoe, MBBS, FRACS · Answer

Hi Jasmin

	In my practice, I don't remove the drains after a tummy tuck that early (day 1), so that I can keep the wound dry. If your plastic surgeon's practice is to remove the drain that early, then some leakage is probably normal. 

	Managing the open area with regular washes and antibiotic ointments seems like a good idea. Seeing your plastic surgeon to get your wound/scar reviewed is your safest course of action. Over the phone advice does not allow (force?) a surgeon to check your wound themselves and adjust the plan if it is needed.

	Good Luck

	Dr Gavin Sandercoe

Tom J. Pousti, MD · Answer

Some drainage from the incision line after tummy tuck surgery is commonly encountered. The important thing is to rule out complications that may be associated with increased drainage from the incision line. Your plastic surgeon will be your only reliable resource when it comes to ruling out these complications; therefore, close follow up with him/her will be important.

	 Best wishes.

Jeffrey Zwiren, MD · Answer

Drainage from an abdominoplasty incision is not unusual and is of no particular significance.  Continue to follow your plastic surgeon's advice.

Jourdan Gottlieb, MD · Answer

A photo would help. 

	Chances are this is the site of a suture just under the surface of the draining site, and that the drainage will continue until the suture is removed or dissolves. Check back with your surgeon next week if this has not resolved.  All the best.

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