American Society of Plastic Surgeons
For Medical Professionals
 
MeandaSat
5 months ago
Answered

Incision not healing

I am 4 weeks post op and my incision is not healing. My surgeon keeps saying it will heal…eventually. I feel that he should send me to wound care. Instead he is telling me to pack it with just a gauze each day and let the water run over it in the shower.

I would like opinions on what you would do if I were your patient.

Procedure: Tummy Tuck
Location: Louisville, KY

Replies 4

Raffy Karamanoukian
ASPS Surgeon

Some wounds may take more time to heal. Proper diet with adequate protein and Vitamin C can help. Usually, this wound will granulate and close in but this may take time. Discuss your concerns with your surgeon who may want to debride the wound at some point and discuss timeframes for success in woundcare and healing.

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Rahul Vemula
ASPS Surgeon
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Based on the picture shown here it looks like there is necrotic or nonviable tissue present in this wound. This would would benefit from Debridement which is a procedure to cut away al of the non viable tissue. ONly then will the wound start to heal. Please speak with your surgeon about the timing of the debridement.

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Alfred Antonetti
ASPS Surgeon

A wound care center is not going to do anything other than a waste of time and money. The best qualified person to take care of this problem is your plastic surgeon. He is correct in telling you that it will heal but it will probably take a couple of months. When it all heals, it is not going to look bad at all. There are many ways to treat this problem and one is not necessarily better than the others. If you were my patient, I would debride your wound and this can be done in the office. I would pack it with Betadine or preferably Silvadene daily. I would tell you not to smoke at all if you smoke and I would see you at least twice per week for awhile. I certainly would consider the use of a negative pressure dressing such as a "PICO". This would heal the wound in a fraction of the time. I would use it for 2 weeks or so. It may be a little expensive but would be worth it. Ins may cover it or your surgeon may help you a little with this. Ask your surgeon about 1) Debridement 2) PICO

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Sasanka Chatterjee
ASPS Int. Surgeon

There is very little to add to what Dr. Alfred Antonetti has said. Do you suffer from any co-morbidities like Diabetes, Collagen disease or vasculitis ?Debridement and negative pressure wound therapy will hasten your recovery. Even if NPWT is not applied, it will heal albeit with a little longer period of recovery following debridement and dressings.

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