American Society of Plastic Surgeons
For Medical Professionals
one year ago

Open wound

My Dr had to open my incision because one of the drains was stuck then he sent me home to stuff with gauze. I was concerned bc the incision was so open that I went back. He removed the black dead skin that opened my wound even more. He told me to again stuff with gauze. This just doesn’t seem right having an open wound this big. Help?

Procedure: Tummy Tuck
Location: Tacoma, WA

Replies 5

Carlos Quintero
ASPS Int. Surgeon

Hi, this condition needs urgent hospital care. Usually the wound is bigger than what can be seen. The urgent goal is to get rid of the unhealthy tissue and possibly start the wound care with negative pressure therapy.

Hope this is helpful to you.

Samir Shureih

Agree with Dr. Quintero, such wound and necrotic tissue and the redness surrounding the wound require major debridement, cultures of the wound including tissue culture and appropriate antibiotic treatment (with help from infectious disease specialist). Professional wound care, proper medical care. May take several months to heal under proper medical and wound care.

Benjamin Van Raalte

I disagree with the other postings. This may not need hospital care. The surgeon that is in place can determine whether there are other signs that require more aggressive treatment. Signs such as a fever, chills or palpation of the skin flap all will determine whether there's infection that requires more care than outpatient. Unfortunately this type of complication happens and is not due to any thing the surgeon did wrong. It is always unpleasant to both the patient and the surgeon and does have a longer recovery.

Alfred Antonetti
ASPS Surgeon

You had an abdominoplasty complicated by necrosis of the abdominal wall. This does not happen very often at all with abdominoplasty but it certainly is one of the possible complications from the procedure. Seems that most of the dead tissue has been debrided already and the wound is starting to get under control. There is no need to be hospitalized at this point unless you develop a roaring infection with sepsis. This is not likely to happen at this time but it could. Treatment for this is with packing the would with gauze as you are doing. It will take some time, probably a couple of months or more but eventually will heal. Huge inconvenience but it can happen. One way to speed the process quite a bit is by the use of negative pressure dressings which will require a small portable machine attached to a small tube. Your surgeon should be familiar with this type of treatment. You need to be seeing your surgeon quite often to keep track of the wound. I am more in agreement with Dr Raalt

Rahul Vemula
ASPS Surgeon
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Sorry to hear that this happened.

This is what is called full thickness necrosis. All the non-viable or dead tissue should be removed. Some of this can be done under local anesthesia but would be better to be done under anesthesia in the operating room.

Following this, you would benefit from having a device called a wound vac to keep the wound clean and to help it heal.

I would also suggest increasing your protein supplementation as this will help heal wounds.

A couple of questions: Are you a smoker or exposure to any nicotine such as vaping, and exposure to second hand smoke. Are you a a diabetic with A1c > 7? These are some risks that can cause this.

Best of luck and wish you a speedy recovery!


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