What should I do with this open tummy tuck wound? I'm 5 weeks post op (Photo)

I am so sorry you are experiencing this, but it is a fairly common complication after Tummytuck , especially in smokers. Follow your plastic surgeon's recommendations and it should heal soon. If he or she is not board certified, you may want to get a second opinion, good luck.

You've had some necrosis of the skin and fatty tissue at the most common area of occurrence--the middle of the lower abdominal tissues. The blood supply to this healing wound is poorest here. That is why these healing issues occur here and why it takes so long for it to heal once the necrosis has occurred. The treatment being rendered by your surgeon is reasonable. You should follow up with him so that he can monitor the wound and discuss other options with you which may speed the rate of healing.

This wound will heal by granulation over time with local wound care dressing changes and debridements that need to be directed by the plastic surgeon.

Sorry you're having problems.  You have a small area of full thickness skin loss, and, possibly some fat necrosis.  It has occurred in the most common site, i.e., in the central most distal part of the skin flap where the circulation is the poorest.Generally this problem is dealt with fairly conservatively with removal (debridement) of any non-viable tissue as necessary, dressing changes, and allowing the wound to heal in.  Any revising (if needed) is saved until the healed wound is soft and mature, usually at least 6 months post-op.  There are many options for dressings.  These include saline wet to damp dressings, Calcium Alginate dressings, or even a wound "VAC" for severe cases.  I recommend you talk this over with you Plastic Surgeon to see whether any of these options might get your problem resolved more quickly.Best of luck.

You have a small area of full thickness flap loss. These usually are best treated conservatively over some time. I would clean the area with peroxide, apply triple antibiotic ointment and keep occlusive dressing such as Telfa covering the area. Occlusive means do not let the area dry out.This will slowly separate and may be conservatively debrided by your PS. As the area begins to fill in over the next several weeks, this may require a secondary wound closure but that is a discussion with your PS.

While it is probable that this will heal with a bad scar within a couple of months,  rather than wait and be restricted in physical activity this long, I prefer to excise and close the wound under local anesthesia in my office.  The longer the wound stays open, the higher is the risk for infection, and the longer you have to look at it.