Can't get my fat belly to close

Hi, I had a TAH with vertical incision done on March 18, 2009.
The surgeon closed with three white foam wicks and a wound vac with no drainage noted 5 days post-op. Wound vac was removed and on day 8 I started with a seropurulent discharge. I was advised to clean deep with a peroxide swab and dry dressing. Day 11 I abscessed and was re-opened, wound vac was reapplied on day 14. The pain was immeasurable and it was removed 4 days later with wet to dry wound packs being done daily. Finally on day42 post -op I was sutured closed. today 55 days after the initial surgery the sutures were removed and guess what. Yep, the incision reopened. Since day 8 I have had a copious amount of discharge. The physician has not seemed concern about this, as other than the initial wound vac (which had NO drainage), I've yet to have a surgical drain. I've been on clindimycin for the past 4 weeks. I complained about draining a serosanguinous discharge 4 days back and was told it was okay as I am afebrile and without pain. The amount then was about 8 oz. Today after the sutures were removed and the physician gently pressed on my abdomen the wound opened and again about 8 oz of fluid came out . The only change this time with the wet to dry dressings is that the wound is actually BIGGER than before. Granted I cannot see my liver this time, I have lots of new scar tissue and it is a very clean wound. Has anyone had or heard of this kind of thing? I am starting to get very discouraged. I know that fat (adipose) tissue is hard to close, but come on. Thanks in advance for reading all of this. Stephanie

Hi Stephanie,

I know exactly what you are going through. I have been dealing with an open incision since march 14, 10 days after my second surgery. I as well had the wound vac in but mine was in for 4 weeks. Its only been out a week and a half now. I am still open 4 1/2 cm now but it is closing finally. My incision like yours opened up bigger and was so deep you could see my muscle lining and the internal stitches. It was very painful and very frustrating and as a matter of fact it still is. I am now atleast off the stronger pain meds and not having to run to the doc office every 2 days. I was as well on antibiotics for 30 days had two yeast infections and grew very very frustrated. The only that helped me was after a month of seeing my doc and making no progress I asked to be sent to a wound specialist and if the wound vac wouldn't have gone in I still would have been open 9 1/2 cm x 2 in deep.... Are you eating lots of protein????? I had to go on boost drinks and I was drinking two of those a day... As well increase your vitamin C, get lots of rest... I hope this helps.. it is hard though going through this surgery is a big enough deal and dealing with all the fun stuff that goes with it but this experience for me was a living H*** and its not over yet!!!! But it is getting much better... If there are any questions you have and I can help please go ahead and post and ask.... You don't have to do this alone!!!

Good luck,
Charity

Charity, Thank you for your encouragement. I am glad to know that I am not the only person who has had the lost section of the Grand Canyon on her tummy. I've thought about wound care services and even about just getting a tummy tuck to cut it off, but without weihgt loss the latter is pointless. Yes I do drink the protein supplements and take Vit. C, as well as MV and Zinc. I grew ( new granulated tissue into the black sponge within 24h after the dressing change) into the wound vac on the second go round with it. Home health refused to remove it due to the pain and I spent the evening in the ER having it removed, so you see my reluctance to go back to the wound vac. I am not meaning to pry, but, did your incision drain afterwards. Mine is like a geyser. I am changing the out (dry) dressing 2-3X/day. I thought breast leakage during the baby days was bad enough, but belly leakage is much more embarrassing. Thank you so much for letting me know that I am not alone in this. Stephanie

Stephanie,
I am sorry to hear of all of your post op problems. I cannot give you specific medical advice but I strongly advise you to ask your Doctor for a referral to a wound care specialist. Peroxide in a deep surgical wound is DANGEROUS. It can cause air embolisms unless it is very diluted. It is also damaging to the new cells that are trying to heal the wound. Wet to dry dressings are also not highly recommended anymore. There are much newer wound dressings that can be left on the wound for longer periods of time there by decreasing the number of times the wound is exposed. Sometimes a CT scan or MRI is done to pinpoint an abcess or problem. The underlying problem needs to be addressed: why is it repeatedly opening up? Where is all of the drainage coming from?

I hope you can get this to heal up as soon as possible. You are in my prayers,
Peacefulmoon

Ditto on seeing the wound care specialist. My problem was not nearly as bad as what you ladies are experiencing, but seeing a specialist makes all the difference in the world. I can't recommend and praise them highly enough!

Hi Stephanie,

For me before the wound vac went in I was seeing my surgeon every two days and he would take a scalpel and scrape the fibrous tissue out, it was very painful and I definetly would have to take my pain meds before and after seeing him. I would have a pad over my incision and it would have to be cleaned 3-4 times a day and I would wake up covered in drainage. I swear by the wound vac like I said if it werent for that I still would be open up to 9 1/2 cm. I overdid it yesterday and DH said that i had torn so I guess I best stop until this thing is fully closed........ In my opinion get into to see a wound specialist ASAP. Is it your surgeon that has been treating you? Like the other girls said there are other ways to help but I no I was never wet/dry packed because it was way too deep.... Atleast the wound vac would suck all of the drainage out but you need to be looked at ASAP.... As well the longer the incision is open you are at risk for infection and a hernia which are both dangerous this soon Post-OP... Please look after yourself and take it easy.... And no you are not alone I am right here beside you, going through the same thing!!!!

P.S. I never used peroxide either it was cleaned with a saline solution, never never never peroxide.


Charity

((czarinasteph))

I am so sorry you are having such a rough time! I agree with several of the other posts--ask for a referral to a wound care specialist.

Please keep us posted!