Am I doing something wrong? Incisions of tummy tuck have opened? Will this heal normal? (Photo)

Question

I just had a tummy tuck 18 days ago and 1 week ago at my PS took the staples out and saw that part of my incisions have opened up. He did not seem concerned. I have a giant hole in my mid incision that is not healing and it is still bleeding a lot of blood. I have been putting non stick gauze on it and wearing my compression garmet. I also air dry the area as well. I'm not a smoker and am very healthy. Will this heal normal? I'm afraid I will have a giant gash on my belly.

Jose M. Soler-Baillo, MD, MS · Answer

Thanks for your question. It appears that you had some wound healing issues resulting in skin loss in the lower abdomen. There are many factors that can contribute to this but the issue is how you will heal. It will take several weeks to months to close with topical wound care then you will be able to revise the resulting scar. After this you can talk to your plastic surgeon about the next course of action. All the best,Dr. ResultsMiami, FL

Aldo Guerra, MD · Answer

Hello Mandie. I'm sorry to hear about your wound complication. Wound delays and open wounds after tummy tuck are not uncommon and if managed promptly should lead to a reasonable outcome. You need better therapy than just "air dry" your wound. You need to talk to your PS ASAP for evaluation and instructions. Best wishes, Dr. ALDO.

R. Brannon Claytor, MD, FACS · Answer

Tummy tuck procedures are surgical procedures which may involve post operative complications. Complications may include infection bleeding hematoma, delayed wound healing or wound opening at the closure site.Close follow up with you board certified plastic surgeon is advised.

Dana Goldberg, MD · Answer

Wound healing problems occur from lack of blood flow to tissues. This can happen for many reasons, but luckily, it usually heals well. You have lost a superficial area of skin, which generally heals better than losing when you lose both skin and fat. Every surgeon has different strategies for wound healing. What you are doing now is fine, and as long as you stay in touch with your surgeon and avoid infection this will heal without additional surgery. Scar revision may or may not not even be needed, but if it is, I'd wait at least 6 months to even consider it. The more your tissues soften, the better your final result will be.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry and sorry for your struggles.  I am glad you are not a smoker as this would have made the wound difficult to heal.  Keep seeing your plastic surgeon regularly for wound management.  Once healed, give the scar sometime before considering any revision surgery,  Good Luck.

Tom J. Pousti, MD · Answer

I'm sorry to hear about the complication you have experienced; Although understandably distressing to patients, these types of wounds 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 reached 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.

Jules Walters, MD · Answer

You appear to have had some wound necrosis.  Follow your wound care instructions provided by your plastic surgeon.  This will close up in a few weeks and may require a scar revision that can be usually performed under local anesthesia 6 - 12 months from now for optimal scar management.  Hope this helps!

Jourdan Gottlieb, MD · Answer

This wound opened because there was some tissue loss (necrosis).  This is more common with smokers, but can occur in non-smokers. Your surgeon should be your best source of wound care advice. Usually wounds heal better when they are moist, so I would disagree with letting the area dry out. Expect 6-12 weeks before this is closed, and then you should allow 6-12 months for the scar to mature before contemplating secondary surgery for the scar. All the best.

Darryl J. Blinski, MD · Answer

Sorry to tell you that you have a wound healing complication of wound dehiscence and necrosis that is clean. Healing by secondary intention will take 2 to 3 months. Than scar maturation of 6 months before scar revision can be attempted...Did not your PS tell you this???

Suman K. Das, MD (retired) · Answer

I would recommend wet to dry dressing with moist saline gauge and keep it covered.Do it twice a day.This wound will heal but will take time.You should get some advise from your operating surgeon first.He may have a better idea.But,I would not keep it open or keep it dry.Good news is it will heal provided if you keep infection away.Stay in touchn with your doctor.

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