Is this normal or is this infected? Should I be worried? (Photo)

8 weeks tummy tuck post op. I've been having troubles with this right side ( the end of the incision healing up) a couple nights ago I had a big chunk of plastic come out of it ( a dissolveable staple I think...) I've been keeping it covered in neosporin and a band aid. I had another suture come to the surface so I cut off the part that was sticking out and then again today I had a suture knot come out. What is going on. Am I going to be left with a horrible scar??!!

Doctor Answers 2

Neither normal nor infected--wound breakdown from stitch abscesses. You should stop self-treating this!

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At this location in your tummy tuck incision (laterally), this is not wound dehiscience due to tension, but rather dissolving sutures (I'd wager they were braided sutures, like Vicryl or Dexon) that have become contaminated by skin bacteria. This causes localized wound breakdown. There are indeed bacteria present, but this is not treated by oral (or intravenous) antibiotics, but good local wound care.

This involves removal of the contaminated sutures where they are evident, which "cures" the local area of breakdown and starts the healing process anew..

I'm not saying there is no case for antibiotic coverage to minimize the potential for these locally compromised areas of your incision from becoming infected, but that while bacteria are involved, good wound care is much more important than taking a certain antibiotic.

Neosporin may actually be part of your problem, because triple antibiotic ointment contains Neomycin, which causes an allergic hypersensitivity reaction in as much as 10% of those patients who use it chronically on an open area. That may be the largest contributor to your open wounds at present, more than the contaminated dissolving stitches that probably started all of this. I would recommend Silvadene rather than any kind of topical antibiotic ointment, or if not that, then Bacitracin. Hydrogen peroxide is another common remedy, but except for grossly purulent wounds (once), peroxide can inhibit healing by killing not only bacteria but skin cells. Saline moist to dry dressings may be recommended, but you really need to see your surgeon for direction of this post-op complication before it worsens.

Yes, this will result in a wider scar, but once everything is healed, local anesthesia excision can remove the unsightly scarring and replace it with the thin line you would have otherwise had. You need active care by your plastic surgeon. Make an appointment ASAP. Best wishes for a good final result! Dr. Tholen

TT and wound concern

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Thank you for your question. I am sorry this happened to you. It look like wound dehiscence. Does not look like infected, but hard to tell in the picture. I would recommend to talk to your PS. You need a local wound care and it should heal ok and your surgeon will guide you

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