Necrosis and infected wound. Close it or leave it open? (Photo)

I am 5.5 weeks post tummy tuck and have had a major infection along the incision line. it is now an open wound and being looked after by the emergency system and now primary care who are changing the dressings daily and cleaning the massive hole. My PS wants me to go back to see him and have the wound closed but the consultant here says it should close from the inside out as it was so infected but that could take months to heal I am looking for advise from others as I am so confused and dont kno

Doctor Answers 4

Necrosis and infected wound. Close it or leave it open?

I'm sorry to hear about the complication you have experienced; these types of open wounds do occur occasionally and (with good care) tend to heal over the course of several weeks. Sometimes, as you know, the area may look worse before it looks better. Most often, even larger open wounds have healed by the time a patient reaches the two months post op mark.

These wounds go on to heal through a process of contraction where the tissues heal from the sides towards the center of the wound; occasionally, removal of unhealthy tissue (debridement) and/or removal of exposed sutures, may expedite the healing process. 

 

Wound care regimens will differ from one plastic surgeon to another. Generally, this will involve application of some type of sterile dressing ( in my practice I use a non-stick dressing covered by a sterile dressing).  Sometimes, for larger wounds, the use of a " vacuum assisted device" (VAC) may be very helpful.  

Also important to concentrate on a healthy diet, including good protein source.

Best wishes.

Abdominal wound problem

I am very sorry you are having such problems. These wounds require experienced doctors and nurses to look after them and I would respectfully suggest that the Emergency Services and Primary Care system is unlikely to be able to give you the best treatment. I would strongly recommend you seek an opinion from an experienced plastic surgeon in your area who can examine the wound closely and decide whether you need ongoing dressings, negative pressure dressings (VAC) or surgical removal of dead tissue. Or all three. Best of luck.

James Murphy, FRCS(Plast)
Manchester Plastic Surgeon
4.8 out of 5 stars 89 reviews

Tummy tuck - infected wound


That's a complications one doesn't see a lot.  It is possible to surgically really clean the edges well and restitch the region however it is a bit risky as recurrent infection is the big risk.  The safer, but longer approach is to continue wound care until a scar forms over.  BOTH options are probably safe but I would probably recommend continuing longer with wound care with periodic surgical cleaning of the wound called debridement.  At least a month longer seems safe then consider having your plastic surgeon excise the area and restitch it so you don't have to wait for months.  Best Wishes!!

Plastic surgeon evaluation of tummy tuck wound

I am sorry to hear about your tummy tuck wound.  I do think that you will benefit from having a plastic surgeon take a look at your wound periodically and recommend care.  Debridement of non-viable tissue surgically will help the wound healing process along.  You should also consider negative pressure dressing (wound VAC) to help expedite the wound healing.  These two things will help the wound healing process exponentially.  Closing the wound may be a possibility but often the wound developed because of sufficient blood supply or two much tension which are essentially the same thing.  Closing the wound may re-create this issue by placing tension on the incision.

Good luck with your tummy tuck healing.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 154 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.