Debridement of the necrotic tissue will expedite the healing process. The antibiotics may be helping but removal of the dead tissue is what you really need.
This can be done with leaving the wound open to heal secondarily or by closing it over a drain of there is enough laxity present. I would discuss these options with your plastic surgeon and see if either he/she or someone closer to you can be of assistance. (Remus Repta, MD, Scottsdale Plastic Surgeon)
Nicotine and tummy tuck problem
Nicotine causes the tiny blood vessels to clamp down and this can cause your wounds to not get enough blood flow to heal properly.
I think that you’re doing everything that you can at this point. I would make sure you avoid smoking and all nicotine products, make sure you are eating a healthy diet with plenty of protein, take a multivitamin everyday, and follow up very frequently with your surgeon so that he/she can monitor for signs or symptoms of infection.
Long term you should heal if you do these things and if there is any problems with the appearance of the scar, this is usually fixed easily down the line with a little touch up. (Sacha Obaid, MD, Dallas Plastic Surgeon)
Necrosis after tummy tuck
This is not that uncommon. Just follow up closely with your doctor. It will eventually heal but will take some close follow up. (Michael A. Fiorillo, MD, New York Plastic Surgeon)
It is unfortunate that you are 4 hours from your surgeon, but I think you need to see him. Sending pictures can be beneficial, but your surgeon can’t treat the picture. You look like you need to be seen. (Gregory Sexton, MD, Columbia Plastic Surgeon)
Necrosis Of Skin After A Tummy Tuck – What Do I Do?
The skin death (necrosis) at your tummy tuck incision allows bacteria to enter your abdominal incision. This bacteria needs to be cultured to be sure your antibiotics are the right ones for whatever bacteria is growing. Your plastic surgeon can recommend someone in your area to do a culture.
This will then take 3 days to determine if you are presently taking the correct antibiotic. You need a face to face evaluation to be sure there is not a collection of fluid (seroma or hematoma) present which could lead to a very significant problem if not treated. Again, your plastic surgeon can recommend someone in your area such as a general surgeon.
The treatment is quite simple, to open the area under the necrotic tissue, place some antibiotic gauze into the wound which will instantly cure the problem, and/or prevent future problems. All of this requires seeing a surgeon, preferably your plastic surgeon, ASAP. In my practice, I would certainly consider hyperbaric oxygen as a very useful modality to treat and/or cure infection, potential infection, and speed wound healing. (S. Larry Schlesinger, MD, FACS, Honolulu Plastic Surgeon)
Infection after tummy tuck needs to be treated aggressively.
I think you are getting worse and should go see your plastic surgeon right away. You are swollen and red, which suggests an infection and maybe fluid accumulation (seroma).
I would get a sonogram. Necrotic tissue should be covered with Silvadene antibiotic cream around the clock. (George J. Beraka, MD (retired), Manhattan Plastic Surgeon)