Is this a suture abscess or a possible infection? (Photo)

Question

I had a tummy tuck April 15th... everything went well until 2 weeks ago when I noticed a spot about 1/2 an inch in length with some puss. I went to my plastic surgeon and the medical assistant said it was a suture abscess that it would heal on its own. I've kept it clean and have been applying OTC antibiotic ointment. Now it's almost a week later and it doesn't look better. In fact when i cleaned it today i got puss and blood and also noticed two black spots. Any suggestions?

S. Larry Schlesinger, MD, FACS · Answer

Thank you for sharing your photograph and question.  Normally, an infection would show more redness and swelling.  The picture you sent us is a classic sample of what is known as a stitch abscess.A stitch abscess is when the body tries to dissolve a stitch.  It sends in white blood cells whose enzymes try to dissolve the suture but for unknown reasons, fails to do so.  This leads to a swollen pimple like area, which when opened, gives off pus which has all the signs of a bacterial infection but no bacteria.  Also, at the base of your picture, one can see a suture.If you were my patient, I would remove the suture which then allows the body to heal faster.  I disagree with using over the counter antibiotics because they often lead to an allergic reaction which turns red and makes you think you are infected, then you use more antibiotics which then turns red, etc. etc.  I like topical antibiotics like Silversulfadiazine cream or a generic Bactroban.  All the above mumbo jumbo means I don't think you are infected.

Christian Subbio, MD · Answer

I agree with your plastic surgeon.  Continue to care for this as he or she instructed, and it should get better in short time.Best of luck!
Dr. SubbioBoard-Certified Plastic SurgeonNewtown Square/Philadelphia, PA

Michele A. Shermak, MD · Answer

You should call the plastic surgery office back to get eyes on the area and treatment recommendations. One week is not long and there may be multiple sutures like this one that are absorbing and coming through the skin. Washing well with warm soapy water, nothing harsh and topical ointments are the treatment. If there is an infection, a prescription ointment may be necessary.

Adam Tattelbaum, MD · Answer

Most doctors use disolvable sutures under the skin. Despite the fact that they are dissolvable the body will sometimes have a local reaction to them and "Spit" them out. That is likely what is going on here. While it does not look scary please just check in with your PS to be on the safe side to make sure nothing more is going on.Best wishes.

Camille Cash, MD · Answer

Your photo appears to show a suture abscess.  These typically heal well with minor home care.  Continue to follow the advice of your surgeon and report any changes or concerns.

Matthew H. Steele, MD · Answer

Thank you for your question and photo.  Sorry to hear about your healing problems.  I agree with your surgeon,  looks like an are of slow healing due to a suture abscess.  Generally these will heal on their own with local wound care.  It may take several weeks for it to heal, so be patient and follow your surgeon's instructions.  Of course, if things appear to be worsening, give the office a call and they may see you sooner.  Good luck.

Steven Wallach, MD · Answer

It is likely a stitch abscess. Local wound care often heals this up pretty quickly. To be sure, check with your surgeon.

Adolfo Sesto, MD · Answer

First, there is no sign of infection. This could be one of two thins :1. A ingrow hair of one or 2 folicles included in the scar, or2. One of the internal absorbable stiches os sutures that kept place in a non well vascular place and is coming out, taken its time.Be patient and conitnue with your ointment.

Is this a suture abscess or a possible infection? (Photo)

Answers (8)

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