10 Months post op - Pseudo bursa? (Photos)

Had drains, wore binder (longer) than needed, (braided) sutures, PS board certified. 3 mo post op, I suspected 'fluid' (Dr. Did not agree) 6 mo, 7 mo & 9 months post op, more surgically removed sutures. Pus & blood draining 5 continuous months. He says it's a reaction to sutures. went to GP for ultrasound. I see mass with channel leading to 'hole'. My PS ( has done MANY TT's) has not had patient Peusdo bursa. Do many PS see/repair these? How is bursa diagnosed Can this still be fluid

Doctor Answers 8

Sinus Tract

You have a sinus track that usually extends down to an infected suture. Sometimes the surgeon can reach and cut it out in the office. If he/she is unable to reach  it, them one may require a mini procedure to get it out. 

Chronic Seroma

Hello,

I've done many abdominoplasties in my day, but I've only seen and needed to operate on a few. This may likely emanate from a suture used to repair the rectus fascia, as most surgeons like myself like to use a soft, braided nylon that get contaminated with bacteria. The surgery to remove this cavity is technically not challenging, although it calls upon more general surgical skills. The trick is not using drains at the end of the surgery. Like the original surgery, the use of sutures to obliterate the space is crucial to avoiding drains and decrease the risk of seroma. Careful removal of this contaminated cavity (pseudo bursa) with copious antibiotic irrigation will allow the cavity to be obliterated and closed without a drain. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

10 Months post op - Pseudo bursa?

Sometimes these chronic nonhealing tissues need to be removed to reveal healthy tissue.  It is always best to ask these questions of your chosen surgeon as recommendations may be different.  

Kenneth Hughes, MD

Los Angeles, CA

When tummy not healed after 10 months

you have to start thinking of ways to get the wound closed.  If your sinus has a tract that goes under the skin flap, and its not getting better with wound care, its time to remove the sinus and tract and revise your tummy tuck.  In my practice, the cavity is stained blue and everything blue is cut out.  Then the abdominal flap is mobilized and the wound closed, using different sutures if the sutures are truly reacting this far out from your procedure.  Best wishes to getting this resolved.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Suture reaction

Thanks for your question. I have certainly had patients who have reacted to sutures in the past, but fortunately the wounds have all healed in when the suture material was removed. Now that you have an established sinus (or pseudo bursa) it is best treated by removing it surgically.

Anthony Barabas, MBBS
Cambridge Plastic Surgeon
5.0 out of 5 stars 8 reviews

10 months post op - Pseudo bursa?

Thank you for sharing your question and photographs.  It is difficult without an in-person examination of determining the cause of your poor wound healing but based on your history I would recommend a revision to remove any remaining undissolved suture material and any scar tissue preventing wound closure.  Best wishes for a quick recovery.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Exploration and revision

Thank you for the photos and question and unfortunately you need to have the sutures and pseudobursa removed.  So see your surgeon or other expert in the area that can help you


Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 60 reviews

Wounds after tummy tuck surgery…

I am sorry to hear about the problems you have experienced. I think that your plastic surgeon is correct and that these types of problems are related to underlying sutures (braided).   I also think that you may continue to have these types of problems until you undergo exploration of the abdominal wall and have all of the previously place plication sutures removed.


 Best wishes.

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.