What Can Make Necrosis Along A Tummy Tuck Incision Heal Faster?

Q: Dr. Eppley, I had a tummy tuck done three weeks ago. I developed a problem within the first week after surgery. At the crossing zone of the inverted T incision, I developed necrosis and infection. Now it is just a big black patch around it. Is there anything that can be done to make it heal and heal faster?

A:  What you developed, as you have described, is a zone of tissue necrosis at the areas of a tummy tuck which has the least blood supply to the skin. It appears that you have had a combined vertical and horizontal tummy tuck and that junction where all the incisions come together  would be at the greatest risk for exactly that problem. While initially dark in the first few days after surgery, it turns black and becomes hard as the zone of demarcation between good and dead skin becomes quite clear. This dead skin and its underlying tissue is known as an eschar. It would be wise at this point to do nothing and allow this area it to heal on its own. Removing the black eschar now will likely reveal a full-thickness tissue defect right down to the abdominal fascia. It would be best to treat this eschar like a scab. Allow healing to take place to the point where it gets loose and is ready to come off. This will allow for a lot of healing to take under and around the eschar. There is nothing that can speed up this process and it will likely take six weeks or longer before the eschar will lift off to reveal if any full-thickness defect exists underneath.  The eschar should only be removed earlier if infection around the area develops.

Dr. Barry Eppley

Indianapolis, Indiana