My surgeon palpated my “significant” edema at my f/u. He could not find evidence of Seroma and even tried to drain the tender area, with no luck. He suggested that although very rare I may have loosened or broken some of the sutures due to a post operative cough and would require another surgery to repair that. When he left the room I asked the RN how often this happens. She said in 7 years she has never seen it. What diagnostic imaging can confirm ?
January 11, 2018
Answer: My muscle repair may have failed By the look of your picture with the drain still in place, it looks like you are still very early out from surgery. While there is the possibility of having broken the sutures that have tightened the muscle, another possibility would be a hematoma (blood collection) in the muscle that could have been the result of coughing and would also cause a tender bulge. Often this cannot be drained early on and simply needs to resolve on its own. An ultrasound could help confirm the diagnosis although a CT scan would likely be more accurate to detect muscle separation/suture failure, but unless there is a plan for intervention based on the results of the imaging study, it is likely to be a waste of time and money at this point. Instead, it would probably be best to watch the area as you heal and see if it resolves on its own. Even if the sutures have broken and need to be repaired, most surgeons would recommend waiting several months for the swelling and scar tissue to resolve before taking you back to surgery. In all likelihood you will be fine, but it's important that you maintain close follow up with your surgeon. Best of luck with your continued recovery!
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January 11, 2018
Answer: My muscle repair may have failed By the look of your picture with the drain still in place, it looks like you are still very early out from surgery. While there is the possibility of having broken the sutures that have tightened the muscle, another possibility would be a hematoma (blood collection) in the muscle that could have been the result of coughing and would also cause a tender bulge. Often this cannot be drained early on and simply needs to resolve on its own. An ultrasound could help confirm the diagnosis although a CT scan would likely be more accurate to detect muscle separation/suture failure, but unless there is a plan for intervention based on the results of the imaging study, it is likely to be a waste of time and money at this point. Instead, it would probably be best to watch the area as you heal and see if it resolves on its own. Even if the sutures have broken and need to be repaired, most surgeons would recommend waiting several months for the swelling and scar tissue to resolve before taking you back to surgery. In all likelihood you will be fine, but it's important that you maintain close follow up with your surgeon. Best of luck with your continued recovery!
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January 11, 2018
Answer: Muscle Repair Failure Hello,Your photo of your abdomen while seated is not telling. My recommendation is if there is a fullness that is fluctuant (like a water bed), then it's a seroma and it needs to be managed. If not, it is likely swelling. It would be unlikely you have a seroma with drains in place. Fears of muscle repair failure are unwarranted unless you had substantial intra-abdominal fat prior to surgery. Best to be patient. Best of luck!
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January 11, 2018
Answer: Muscle Repair Failure Hello,Your photo of your abdomen while seated is not telling. My recommendation is if there is a fullness that is fluctuant (like a water bed), then it's a seroma and it needs to be managed. If not, it is likely swelling. It would be unlikely you have a seroma with drains in place. Fears of muscle repair failure are unwarranted unless you had substantial intra-abdominal fat prior to surgery. Best to be patient. Best of luck!
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