My tummy tuck incision is spitting stitches. What should I do? (Photo)

Question

My doctor does not seem very concerned about it. I have consulted multiple times and have just been told I am spitting stitches. He does not plan an intervention or debridement. Area does not seem to be closing and I am very concerned. I am 18 days post surgery. What should I do?

Corey Harkins, MD · Answer

The issue is more than just the stitches "spitting."  You have an incisional dehiscence, which is a separation of the skin where it was sewn together.  The wound needs to be cleaned (debrided) so that you do not develop an infection of the area.  I would recommend making an appointment with your surgeon so this can be taken care of.

Eric A. Weiss, MD, FACS · Answer

Take a deep breath and relax. This is a minor inconvience and not a life threatening problem. You have lost a little skin due to necrosis and the wound has separated due to the tension associated with the abdominoplasty. Having said this, there are some things you can do. Wash with soap and water, apply an antibiotic cream and see your surgeon weekly. He may want to debride the dead skin away. Once healthy granulation tissue starts to form, he(she) may try to close it with stitches. This is called a delayed primary closure and will help it close quicker. Sometimes this works and sometimes it doesnt. I truly believe if you do nothing it will heal up just fine. Depending on the final scar, it may need to be revised, as wounds that heal this way are at higher risk of poor scars.Eric Weiss MD

Darryl J. Blinski, MD · Answer

Thanks for the RealSelf questions. This is NOT suture spitting!!! It is a mild to serious wound dehiscence with skin and fat necrosis... You need daily medical care and treatments to help this area heal. With even minor care it will take a few months to close. I advise aggressive wound care that I can offer in a PM. Otherwise start on PO antibiotics and 3 times a day dressing changes with irrigations. Where was your surgery done and by who???

Jourdan Gottlieb, MD · Answer

The black colored tissue in the photo is non-viable, and the wound will likely heal faster if that were trimmed by your surgeon.  I suspect if you forward these photos to your surgeon he will reconsider. This looks more like a wound "dehiscence" (separation) than spitting sutures. Usual treatment is local wound care until healed. It is uncommon to have to close these surgically, but healing will take timeAll the best.

Paul H. Rhee, MD, FACS - Account Suspended · Answer

As my colleagues have pointed out, you have a more significant problem than just spitting sutures.  You should have your wound debrided and local wound care initiated.  You may also need antibiotics.  I would see your plastic surgeon as soon as possible.It will likely take several weeks to months for this to completely heal.  Once it does, you will have a wider scar in this location that may require revision at some point.

M. Dean Vistnes, MD - Account Suspended · Answer

Schedule an appointment with your plastic surgeon to get appropriate wound care instructions. Best of  luck. Dean Vistnes.

Robert E. Zaworski, MD (retired) · Answer

Contact your surgeon for an appointment.  If necessary, email these photos to his office.  Your surgeon will want to address wound care as soon as possible.  Best to you!

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