What happens when you have necrosis on the incision? (Photo)

Question

Well, here I am on the second week of post op. My ps took me out of my compression put me on an antibiotic and said to let it air dry this week. I developed blisters from the tape. Allergic reaction. I am concerned I'm having part of my skin dying. The circulation around the area is procounced and is greater than the wln >5 seconds. (RN) I've attached a photo to appease your Curiosity ...what do doctors do for this in case. I am slightly worried, yet faithful

Vishnu Rumalla, MD · Answer

Thanks for your inquiry,  the most important thing is to follow your surgeon's woundcare instructions. Most of us will allow the wound to demarcate, remove nonviable tissues and do woundcare.  Good Luck.

Erik Miles, MD, FACS · Answer

Skin necrosis is one of the risks of tummy tuck surgery.  The area where you have the necrosis is the part of the flap that is under the most tension and has the least blood flow. It is therefore the most common place to see skin breakdown.  The area will declare itself. The dead tissue will typically need to be debrided.   Hopefully it will be a minor debridement and the wound will heal with  continued wound care. Your plastic surgeon should be adept at managing such complications.   The long-term outcome is generally good even after a minor area of skin necrosis. You may have a wider scar in that area, however only time will tell if a revision is indicated. Stay in close communication with your surgeon so he or she can manage your issue. Best wishes to you!

Adam C. Augenstein, MD · Answer

It appears that there are areas that have skin necrosis that will further declare itself as to its extent.  In the meantime you should definitely follow your surgeon's advice on treatment and care of this area.  Once fully healed it may require a scar revision or further surgery to improve the scar appearance.

Steven Wallach, MD · Answer

Most surgeons will allow the tissue at this point to demarcate and any obvious dead tissue will likely require debridement or treatment with creams that will help cause the dead tissue to separate. Local wound care is then performed to get it to heal.

Enamul Haque, MD · Answer

Thank you for posting the picture with your question.
There does appear to be some necrosis of the skin with irritation and possible infection. This is a known complication of abdominoplasty, especially if you are a smoker. The blood supply to the incision site is poorest at this location. The current treatment seems reasonable so continue following up with your plastic surgeon.  There may be other options to speed the rate of healing that your board certified plastic surgeon can explain to you.
Good luck to you.

Sanjiv Kayastha, MD · Answer

There are many different ways to treat tissue necrosis following abdominoplasty. In general, I will debride  any obviously dead tissue. After that is completed local wound care is recommended. This involves washing the area twice daily and applying an antibiotic cream like Silvadene. Other options include a VAC sponge and/or hyperbaric oxygen therapy. Stay in close touch with your surgeon and follow their advice.

Daniel Greenwald, MD (in memoriam) · Answer

You have some tissue loss at the most vulnerable area of the abdominal flap.  This is not unheard of and will heal on its own.   Don't worry, be patient, and be prepared for the possible need for revision for scarring or fat necrosis.  Ultimately you will be perfect

What happens when you have necrosis on the incision? (Photo)

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