is this normal and will the scar even or be left with a hole?
Hiand welcome to our forum!Iam sorry that you have experienced a complication of the abdominoplastyprocedure. During the procedure, the abdominal skin and soft tissues areseparated from the underlying musculature from the ribs to the pubic area. Ifthere is impairment of the blood supply to the abdominal skin, the segment ofthe flap the greatest distance from its blood supply may not survive (above themid-pubis). The cause of the blood supply impairment can range from effectsof smoking, diabetes mellitus, vascular disease, previous surgery in thearea (disrupting the normal blood supply), infection, or may totallyinapparent. Treatmentconsists of removal of the unhealthy tissue, followed by intensive wound care. You still have a moderate amount of unhealthy tissue as per your photograph. One looks for the development of granulation tissue, a beefy red vasculartissue, to develop, after which time the wound will begin to shrink. Manywounds of this size will seal over a span of 2-3 months. The depth of the defect is not the important factor as your deeper structures are intact. Some advocate the use of a suctionapparatus (wound vac) to accelerate the process of wound shrinkage. Variousenzymatic topical creams are available. Some advocate hyperbaric oxygentreatments. In our practice we usually obtain excellent results simply with frequent wound management.Afterthe wound seals, and after the scars mature and the inflammationsubsides, one would then consider revisional surgery if necessary (usually6-12 months). Continue close followup and intensive wound care with your plastic surgeon.Bestwishes...
