Opening in my incision and other problems. *HELP*

So it has been 3 weeks since my surgery (abdominoplasty, breast lift/implants, and brachioplasty). At first I thought things were going great. I went back to work after 2 weeks and was doing really well besides being pretty tired. But I ended up having an allergic reaction to the steri strips so I was having insane itching, then I had another allergic reaction this week (no idea to what) my whole face swelled up and I looked like a freak! My p.s. told me I could not take steroids because they would affect my wound healing and benadryl hasn't been helping, but thankfully the swelling has finally started to go down. The latest development is a 1 inch opening in my incision near my hip. My p.s. is 2 hours away and it is hard for me to get to her office now that I am back to work, but I went in Monday morning because the opening in my incision was leaking horribly everywhere! She told me to pack it with gauze soaked in saline and it would close up in a few days, but it still hasn't and the leaking is a nightmare! I have been taping heavy duty pads on it and I have to change them every 2-3 hours and they are soaking wet. Last night I woke up in a puddle. It's freaking me out! What else can I do? Has anyone else had this? How long before it closes up?

 

oh goodness Kendralynn I'm so sorry.  I don't have any experience with this but wanted to let you know I'm thinking of you and wishing you well.

I had an opening in my incision. My surgeon wasn't concerned much either. But, as it seeped more, I became more concerned as well. It turns out, my incision hole had "tunneled". If you're incision has tunneled, then you will actually need to pack the wound with white sterile ribbon. For me, the tunneling required 12 feet of packing ribbon the first time it was packed. This was almost 3 weeks ago. Now we're packing 5-6feet. My incision hole IS closing. BUT (and this is a big "but"), it might need to be reopened if the tunneling hasn't closed. My tunnels ARE closing but because they are so long, the hole is closing faster. My surgeon will probaly have to cut the hole back open. He said to look forwardt o at least 8 weeks of healing and packing.

As for the leaking...
You're leaking normal body fluids (that would cushion internal organs), plasma, and blood. If you're leaking that much, then the ribbon packing will help. I also folded a 4x4 over it, then a folded white washcloth, and then placed a maxi pad over that. I held it all together with my binder. Yes, it's a lot of padding and bulk...but it kept me from leaking all over my clothes. When I slept at night, I would sleep on Chucks (the cotton/plastic backed sheets that they have in hospitals). They sell these also in any parmacy dept. in the incontinence section. They saved my bedding.

Just remember, the hole might be small...but it's what's going on underneath the opening that's significant. And, you should have a medical professional investigate it if you don't want to see your surgeon. 

Welcome to the wonderful world of wound dehiscence.  My t-junction on my belly completely opened up and melted, and I had a horrible leaking hole on my hip. Turned out these were connected under my skin. I oozed and leaked, and packing/compression just wasn't working. Since I had a huge hole in my belly that could see my fascia tissue through, and he was getting worried about infection, my surgeon (my local WLS surgeon, not my TJ PS surgeon) put me on a wound vac. It was pretty nifty if a bit horrifying.
 
First they cleaned out the wounds by cutting away any of the dead tissue and flushing everything with saline (not fun). Then they packed the wounds with foam plugs, sealed it all with sticky plastic and hooked up a suction device that I wore in a small tote bag.  Every few minutes the pump would cycle on and suck the goo out into a canister. What makes this a really good method is that the suction actually forces the internal bits to suck closed and heal faster than the outside, which is being held open by the sponge packing. You don't trap an unhealed portion inside, and everything heals MUCH faster.  My huge gaping belly hole had complete granulated in a little over a week and I was off the pump in about two weeks total... there is no way the packing method will heal a big wound like that in such a short time (it normally takes MONTHS with the packing method). Plus, all your oozey goo gets sucked up into a handy canister than can just get tossed in the trash rather than leaking all over the place ruining everything.

You might consider asking your doc to refer you to Wound Care (so your insurance will cover it) at a hospital closer to you, and then possibly discuss getting a wound vac with them.  Surgeons are like mechanics, they do the technical work... if you want good long-term wound care it's best to go a specialist department for that. It does make a world of difference in a lot of cases.

Open spots have several causes (and therefore several treatments), including infection, a retained stitch, seroma, hematoma, poor nutriition, and excessive tension. 

While wet to dry packing is certainly a good treatment, I emphasize a search for the root cause.  Sometimes a procedure (major or minor) may  be needed to get the situation under control quickly.

Sorry to hear you having to deal with this.  I can relate on a number of levels.
My best advice is to call your surgeon.....he/she may need to see you.  I know it's tough to travel 2 hours, I have almost the same distance to my surgeon.  You don't want to risk an infection so to be sure call and describe it to the surgeon or the nurse they will be able to advise you.  You can probably send them pictures via email too.

FYI - when I had a minor amount of leaking from "spitting a stitch" I packed on the neosporian and covered it with gauze....it took about 2 weeks but it healed beautifully!

Best wishes......hope this gets better for you real soon.

Thank You everyone! I am feeling much better about all of this. It's nice to know I'm not alone.

I'd highly recommend you get to your doctor ASAP.  Have him take labs.  After my plastic surgery in October, my protein and iron levels PLUMMETED!!!  My iron was 20!  The inscision along my back popped open in FOUR places and started tunneling - one tunnel runs down my butt and can't be measured, it's longer than 12 cm's.  I now basically have four holes - one on each hip and two on my lower back, butt area. 

We tried ribbon gauze packing for about two weeks, it just got worse and worse.  I've been on a wound vac for almost two months now.  I've been in the hospital (in November) for blood clots on both lungs with no classic symptoms - it was a miracle we caught it in time.  While in the hospital, I was dx'd with MRSA and was put in isolation.  After being released from the hospital, home health has been to my house at least 3x a week; tomorrow should be my last visit as I will be able to go to a wound clinic.  About December 15th, the home health nurse did a culture on my wound and not only did I have MRSA, but also E-Coli and another nasty infection; I had to be on a very powerful antibiotic.  I haven't been back to work for more than a TOTAL of four days since October 3rd!

I've received bags of iron and I try to eat 160 grams of protein a day.  My protein is at a measley 30 and my iron, while much better, is still a shred low from "low normal".  I have always taken my vitamins like clockwork and my labs were stellar going into surgery.  PLUS I've had both knees replaced in separate surgeries and didn't have a single problem! 

The overall plan is to get my protein and iron up and then I'll go back for another surgery with my plastic surgeon to be opened up from hip to hip to have the incision cleaned out and stitched back up.  Even though I'm healing pretty well with the wound vac, with everything that's happened, especially in the never-ending tunnels, we don't know if there's any more nasty tissue deep down inside.

I have so many doctors involved in this it's not even funny.  I have the plastic surgeon, my WLS surgeon and NUT, my PCP, a hemotologist, an infection disease doctor and the wound vac doctor.  I'll have home health care back in after I have surgery again.

No one knows why this happened to me....everything looked good going in.  I don't blame my plastic surgeon at all....he's been there for me every step of the way as has every other doctor.  I'm just saying take this very, very seriously.  I did and I still ended up in hell.

Good luck,
Jana