A tummy tuck, or abdominoplasty, removes excess skin and fat while tightening abdominal muscles for a firmer midsection. A potential complication, though uncommon, is wound dehiscence, where a surgical incision reopens. This occurs when the edges of a closed wound separate, partially or completely, before healing is complete. Suspected dehiscence requires immediate medical attention to ensure proper healing.
Immediate Steps to Take
If your tummy tuck incision opens, assess the situation without touching or probing the wound, noting if it’s a partial or complete separation. Gently cover the area with a clean, dry dressing or cloth to protect it from contamination. Do not attempt to re-close the wound yourself, apply unprescribed ointments, or clean it with harsh chemicals.
Contact your plastic surgeon immediately to report the dehiscence. They will provide guidance and determine if you need an urgent assessment or emergency care. If your surgeon is unavailable, or if you experience severe pain, excessive bleeding, signs of infection (like pus or foul odor), or visible tissue protruding from the wound, go to the nearest emergency room.
Understanding Why Incisions Open
Several factors can cause a tummy tuck incision to reopen, often within the first two weeks post-surgery when the wound is most fragile. Excessive tension on the incision line is a primary reason, occurring if too much skin is removed or from strain due to activities like coughing, vomiting, or heavy lifting. Internal pressure from fluid collections, such as hematomas or seromas, can also pull on wound edges, leading to separation.
Infection at the surgical site can weaken healing tissues. Poor nutrition, especially a lack of protein, vitamins, and minerals, impairs effective healing. Smoking significantly reduces blood flow and oxygen, hindering recovery. Underlying medical conditions like obesity, diabetes, and chronic diseases also compromise wound healing. Additionally, inadequate post-surgical care or premature suture removal can compromise incision integrity.
Medical Assessment and Treatment Options
When you seek medical attention for an opened tummy tuck incision, your surgeon will conduct a thorough assessment. This includes a physical examination to determine the dehiscence’s extent, depth, and size. They will also check for infection signs like redness, swelling, or discharge, and may take a wound culture. Underlying issues like fluid collections (seroma or hematoma) will also be evaluated, as these can impede healing.
Treatment options depend on the wound’s severity and cause. For superficial dehiscence, conservative management with regular cleaning and specialized dressings may suffice. Negative pressure wound therapy (NPWT), a non-surgical approach, uses a vacuum dressing to remove fluid, promoting healing and preventing infection.
Deeper or more extensive dehiscence may require surgical revision, involving debridement and secondary closure. In severe cases, especially if internal organs are exposed, emergency surgery is necessary. Your surgeon will determine the most appropriate course of action to facilitate healing and minimize complications.
Managing the Healing Process
Managing the healing process after an incision opens requires careful attention. Keep the wound clean and dry, typically involving daily cleaning with mild soap and water or saline solution, followed by careful drying. Regular dressing changes are important; cover the wound with a sterile bandage to prevent contamination and absorb drainage. Your surgeon or a wound care specialist will provide specific instructions on dressing types and frequency.
Monitor the wound for infection signs like increased redness, warmth, pus, or persistent pain, reporting any changes promptly to your healthcare provider. Restrict activities to avoid tension on healing tissues, refraining from strenuous exercise, heavy lifting, and abdominal strain. Nutritional support is vital for recovery; the body needs adequate protein, vitamins (especially A, C, and D), and zinc. Staying well-hydrated also supports tissue health. The healing process can take weeks to months, requiring adherence to your surgeon’s care instructions.