12 weeks post op abdominoplasty. Still have 1 drain in, output of approx 60-80 per 24hours. What to do now?

Compression garment 24/7. Hyperbaric x5. Doctor say only 3 other times in his career, Great! He is suggesting Tetracycline wash subQ. Is this normal and should i give this more time?

Doctor Answers 6

Drain at 12 Weeks, Now What?

This can be a difficult problem to resolve. If your drain has been in for twelve weeks then sometimes it is the drain itself which is causing chronic irritation and thus the persistent elevated drain output. Another issue can be bacterial contamination from having the drain in for so long. If you do not have redness, fever, or cloudy drain fluid then you do not have an infection. Your surgeon is not suggesting the Tetracycline wash to treat an infection, they are using the Tetracycline solution to create irritation of the lining of the seroma pocket in order to achieve a sclerosis of the cavity. This would cause the layers of the seroma pocket to stick together and seal off the pocket so it no longer continues to drain. It is worth trying but it probably won't work.

An alternative approach would be to just remove the drain (assuming this is the cause of the ongoing fluid production) and see what happens. Likely you will develop a seroma which can be aspirated every couple of days in the hope that once the drain is removed and no longer irritating the tissues then the drainage will eventually stop. If the repeat aspirations don't work then you will likely need another operation to remove the persistent seroma which has evolved into a chronic bursa. That may be the only way to completely resolve the problem.

Prolonged Use of a Drain

Hello,Data indicates that your drain and/or the cavity it is in is colonized with bacteria and it should just come out.  You will likely form a seroma, which is inevitable at this point. Data also indicates that regardless of output, it should have been removed at 2 weeks. Best of luck.

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 78 reviews

12 weeks post op abdominoplasty. Still have 1 drain in, output of approx 60-80 per 24hours.

This is so unusual to see in the era of wound closure with progressive advancement sutures. I think you are going to need a surgical exploration, resection of the seroma cavity and reclosure. Just make sure the closure is with the progressive advancement suture technique. You should have the drain out in a week or so. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

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Post op abdominoplasty drainage

Hi socalgrammie,

So sorry to hear about your situation. I would have to say this is exceedingly uncommon especially 12 weeks later. Likely cause would have to be persistent seroma and a chronic inflammation is the basis for this (less likely but is has to be excluded would be an infection/ biofilm) or a lymphatic leak is another possible cause (fluid analysis can differentiate the two). I would suggest that your surgeon analyze the fluid and then excluding other cases treat with a Sclerosant like Tetracycline. The seroma formation could possibly have been prevented with quilting sutures and/or progressive tension suturing techniques. Good luck to you

Gideon Maresky, MD
South Africa Plastic Surgeon
5.0 out of 5 stars 2 reviews

Abdominoplasty - drainage will not stop after 3 months

Thank you for asking about your abdominoplasty.
  • I am so sorry to hear you have this problem.
  • There are two common explanations - the drain itself is irritating and causing the drainage
  • Or there is an infection causing the drainage.
  • Before anything is done you might ask your surgeon for an ultrasound to be sure there isn't a seroma cavity
  • If it is an infection, drainage should stop rapidly with antibiotics.
  • At times, just removing the drain turns out to be the answer.
  • But I agree completely with you and your surgeon that you need a step-by-step treatment plan and get this resolved as fast as possible.
Always consult a Board Certified Plastic Surgeon.  Best wishes. Elizabeth Morgan MD PHD FACS

Tummy tuck drainage

What has happened is that your superficial inguinal node was inadvertently cut over your lower abdominal incision line; after 12 weeks, you need to consider having your surgeon go back in and try to suture ligate the node.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 41 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.