Necrosis and Sepsis After Tummy Tuck: How Long Until the Wound Heals Up?

i had full tummy tuck with lipo 2 weeks ago. i developed sepsis and necrosis of the skin and fatty tissue. the doctors decided not to debride the dead tissue but it's quite a large area and feels like it will never heal. it seems to me that the wound is getting larger altough the black tissue has not grown any larger. the wound seems to be opening up more. should i have had more stitches to close this up?

Doctor Answers 7

Removal of the necrotic tissue is important

Necrosis can be a result of too much tension on incision, poor blood supply, smoking ect.  The necrotic tissue needs to be removed and the wound has to heal from the inside out.  You cannot resuture the wound.  Unfortunately the healing takes a long time but usually does not alter the end result.

Boca Raton Plastic Surgeon
4.6 out of 5 stars 15 reviews

Necrosis and Sepsis After Tummy Tuck: How Long Until the Wound Heals Up?

Before discussing TREATMENT we must understand CAUSE. We need to understand WHY your Tummy Tuck tissue died and became infected. Was it because you are or live with a smoker? Do you have Diabetes or a connective tissue diseases (such as Lupus or Scleroderma)? Was the liposuction too aggressive and resulted in destruction of the blood supply to the skin?

If you had one or more of these conditions, they need to be corrected or improved upon.

I'm not sure why your surgeons decided not to surgically remove (debride) all dead and infected tissues. Such tissue usually allows bacteria to thrive in it while antibiotics and white cells do not reach them there. A debridement procedure or two followed by application of the VAC could truly speed your healing.  These wounds cannot be stitched. They have to be allowed to heal by themselves and after allowing 8-12 months of healing a revision procedure or two may be needed to correct matters.

Good Luck. 

Dr. Peter A Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Necrosis/Wound after Tummy Tuck?

I am sorry to hear about the complication you have experienced after tummy tuck surgery.

The major principles here involve:  removal of necrotic tissue, avoidance of damage to normal healthy tissue, treatment of infection if present, removal of any foreign body that may prevent healing ( exposed sutures),  adequate nutrition/protein intake etc.

Depending on the size of the wound it may take several weeks to months for closure to occur. Again, depending on the size of the wound a wound "vac"  device may be helpful.

Suturing of the incision line is not indicated now.  Closure may be possible later when the wound is clean;  otherwise, scar revision surgery may be necessary  down the line.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Open wound after a tummy tuck

As Dr. Aldea said, the reason for the necrosis needs to be determined and just how large an area is involved you didn't say.  But, the last thing you can do is go back in to stitch it up.  The wound was closed under some tension as all TT's are, and this will cause the wound to want to open up more and will slow down the healing process.  As for debridement, the usual treatment of necrotic tissue is to remove it especially in the face of sepsis.  On rare occasions, with a dry eschar, you can leave it for a little while as the rest of the viable tissues stick down and heal so that when the debridement is done, the wound doesn't want to pull apart as much.  But in the face of sepsis and infection, that would not apply in my opinion.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Necrosis of the skin can happen for many reasons after tummy tuck surgery

You need to discuss this with your doctor.  Any information that you get without full understanding of your situation will only confuse you more.  There is no way to give relevant advice on this problem through this forum.  That being said, wound breakdowns after tummy tuck usually heal up on their own and usually do not require any surgical intervention.  Simple local wound care is usually all that is needed and in a few weeks the wound closes.

Dev Wali, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 56 reviews

More stitches will not help

The necrosis of the skin is rare but it does happen. You need to follow your surgeons recommendations and you will be fine. It will take few months for wound to heal and may need revision later on.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 reviews

Takes time for these wounds to heal

An area of marginal necrosis in the middle is not uncommon. This is the area that is the furthest away from the blood supply and under the most tension. These areas generally take about 4 - 6 weeks to fully heal. Many times the scar will look just fine and other times you may require a relatively simple scar revision. If it is a large area such as yours a revision may be more complicated.  Treatment with antibiotics is only needed if you show signs of an invasive infection.  Simple wound care is all that is required at this time.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

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.