Spitting stitches and open wounds? Will be three weeks post op Monday. (Photos)

Question

Surgeon said leave alone. I have six spit stitches from closed incisions that have opened and the large one never closed and a stitch surfaced. He said there’s no infection but there’s pain inside. I’m using medical grade manuka over it once per day after cleaning with sterile tools and applying gauze but what’s happening?! I’m mortified!!!

Shlomo Widder, MD · Answer

Dear Kelley,   Thanks for posting your pictures. From observing your pictures it appears that you have minor wound healing problems with spitting sutures as you describe.          However,  you do not have to be mortified , since spitting sutures occur  commonly in the  long wounds of  tummy tuck surgery.  With good local wound care and removal of the visible sutures by your surgeon, you should be fine in 2-3 weeks.      If you notice any signs of infection - redness, swelling, cloudy discharge, fever, contact your surgeon for antibiotic treatment, or incision and drainage of an abscess.                        Best of luck,                                           Dr Widder

Rohit Jaiswal, MD · Answer

Occasionally stitches may "spit" or become visible after certain surgical procedures. Sutures such as Vicryl may be more likely to "spit" if they are placed superficially and the wound breaks down. After an abdominoplasty it is not uncommon to see certain areas where the incision breaks down, and sutures may then start to be exposed if they haven't dissolved yet. 
Usually when the sutures are exposed they may get removed in order to prevent them from becoming a nidus for infection. Following up with your surgeon will allow you to get this complication managed. 
Best wishes, 
Rohit Jaiswal, MD
Plastic Surgeon; Las Vegas, NV

Erik Miles, MD, FACS · Answer

It is somewhat difficult to see exactly what is going on with you. It appears that you had a fleur-de-lis abdominoplasty and have some wound healing issues.  It is not uncommon to have slight wound separation or suture extrusion.  These issues are typically managed effectively with local wound care. Sometimes sutures need to be removed when they extrude.  Stay in close contact with your surgeon and follow his or her instructions for wound care. It does take time for everything to heal so try to be patient. Best wishes to you.

Effie Pappas Politis, MD · Answer

Depending on the type of suture used, 3-4 weeks may be the peak of the inflammatory phase of wound healing. As noted, this is not uncommon after large excisional surgeries especially where a horizontal and vertical scar meet. I typically advise patients to perform local wound care given any additional trauma to the area at this time will impede wound healing even more. It should be monitored by your surgeon. I do not offer any scar revisions until at least 9 months after surgery when the inflammation has settled. Good luck and always keep in communication with your surgical team.

Spitting stitches and open wounds? Will be three weeks post op Monday. (Photos)

Answers (4)

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