What causes fluid build up that makes it necessary for post op surgical drain for 4 wks after tummyt

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daydream_725:
I had an extended abdominoplasty and hernia repair that required 1608 internal stitches 4 weeks ago.  At that time the surgeon put a surgical drain in place.  He explained he expected to remove it in 7-9 days.  It has now been 4 weeks.  If removed too soon, I am told that it could be necessary for needle excision of coninued fluid buildup.  What, if anything can I do to help this process along so the fluid buildup ceases.

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Dr. Adam Summers:
Plastic surgeons use drains to remove the excess fluid your body produces after surgery.  The fluid is rich in proteins and other "healing factors" -- there's just too much of it.  Like so many things in life, "a little is good" but "too much is bad".  When a significant amount of excess fluid accumulates, a fluid pocket develops and this will compromise your cosmetic result.

So, the drain is necessary.  Typically, within 2 weeks, most drains are removed.  This is because, as your body heals, it "seals" the channels through which the fluid is produced.  In some patients, the fluid continues to be produced.  This may be from a lack of compression, over activity (frequent or repetitive motion at the surgical site), seroma pocket, or infection.

In your case, an option would be to "place the drain to gravity".  This means that the drain suction is deactivated but left in place.  Basically, you can see if your body can handle absorbing the fluid while still providing a place for excess fluid to egress.  If the collection reservoir does not fill up and you do not get swollen, you may be able to safely have the drain removed.

In rare cases, a secondary procedure is necessary to remove seroma pockets or wash-out infection.  Other options may be applicable also.  Please talk to your surgeon, as I am sure he/she is also very interested in having the drain removed.

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