My Tummy Tuck wound won't close, what is the proper care? (photos)

Hello,We can chastise you all we want, but that's little help to you now. You have a problem that needs to be solved. Fortunately, your life is not in danger, and there appears to be no sign of infection. This is a common problem that is seen to a greater or lesser degree after tummy tucksWhat has happened is the circulation after the surgery became inadequate for healing (lack of blood supply equals lack of oxygen), and skin and fat have died. This is called 'necrosis'.  These wounds develop a fibrinous surface that oozes body fluids and decomposing fat, which looks like puss, but is not. This environment is not conducive to healing, but instead for bacterial colonization. Because there is very little blood supply to these tissues, any of the antibiotics you are taking are doing nothing, except increasing the likelihood for a resistant bacterial strain to develop.You should: 1. Stop taking drugs (antibiotics) that were inappropriately given to you. 2. See a surgeon who is expert in cosmetic body contouring and the care for its complications.  He would be certified by the ABPS and a member of the ASAPS.  This surgeon needs to perform a minor procedure to remove the dead and decaying fatty tissue, and institute a wound care dressing that can be changed by you or a home healthcare nurse on a two to three times as day basis.  These two things alone will induce a healing phase to the wound that will look very different.  It will be bright pink, and will bleed easily when rubbed with a sterile gauze. This is called 'granulation tissue', and is the foundation for wound healing, not antibiotics and butterfly strips.The healing phase may take a month or more before it is completely healed.  You may be left with a scar requiring revision surgery.  Hopefully you have built a relationship with that surgeon, and he'll be able to perform that surgery so that you can finally have the result you were hoping for.Best of luck!

Hi Anelim. I'm sorry that you're experiencing complications from your surgery abroad. You need to see a board-certified plastic surgeon in your area right away to get this wound taken care of. Otherwise, your results and your health are at risk. Good luck.

I would urge all patients considering elective surgery of any kind to select a surgeon in the same city in which they reside or at least in the same state. Going abroad may save a few dollars up front, but may end up costing you much more in terms of your health and welfare as well as money. How can you possibly expect your doctor in Mexico, Kazakhstan, Timbuktu, or wherever to look after your postoperative care once you have returned home? Is it reasonable to expect a US plastic surgeon to look after the problems created by someone else? I have seen much, much worse complications that have resulted from medical tourism gone wrong; so let this be a warning to all.As far as your wound goes, it is not healing because it contains dead fat. You need a debridement (excision of dead tissue) and loose closure round a drain. Please go to a board certified plastic surgeon near where you live and have it dealt with.

You need to find a plastic surgeon near you to evaluate the wound in person.  Since your surgeon is either out of country on vacation or you flew out of the country for surgery, ask his/her office if there is someone near you that they recommend for you to see.  If that does not work, see your primary care doctor for a referral to a plastic surgeon.  It looks like the wound could use a little debridement by a surgeon and local wound care.  I do not suggest trying to close it in anyway now as it needs to drain in order to heal.  

The problem you describe
is indicative of the problem with traveling internationally for surgery. The
importance of a good and trusting relationship between a patient and their physician
cannot be overvalued, especially when things do not go perfectly. Once you leave the office of your surgeon, your best resource is gone too. It would be
impossible to answer your question without seeing you in person. I do
wish you the best in finding a solution but would recommend you seek out a
skilled, board certified plastic surgeon in your area who can examine you and
help make a plan.
Best,
Dr.
Pyle

Wound separation after an abdominoplasty is usually due to marginal necrosis or lack of blood supply.  The area will eventually heal. For now you should keep the area clean with soap and water.  If you develop a fever or unusual swelling or drainage you will need to be seen by a plastic surgeon.  Since your surgery was done out of the country do your best to find someone willing to take over your care.  In this situation I usually ask for a copy of your operative report. 

That is the problem doing out of country surgery. We IN country surgeons do not desire to take the responsibility of surgery we have not done. Try and find a boarded US PS to render care, but this care will be expensive... 

I would go to a PS or infectious disease MD in your area and have the wound evaluated and professional care recommended. I frequently see patients like yourself who unfortunately have a complication after surgery in another country and often wonder why they did not seek out plastic surgeons here in the first place.

Dr. Corbin

You mentioned that you had your surgery in another country.  Your problem is a good example why that was not a good idea.  Contact your surgeon as soon as possible so that he can refer you to someone in your area.  Your new surgeon will need a copy of your operative report to determine exactly what was done at surgery.