Foreign Bodies in Abdominal Surgery Wounds

Foreign body in abdominal surgical wound?

Hello Doctor: My father (55 years old) sought medical attention around September 30 of last year due to a duodenal ulcer.
Initially, there was a delay in seeking treatment, which led to symptoms of peritonitis and septic shock.
He underwent a total of six abdominal surgeries and was hospitalized for a month before being discharged to recover at home.
To this day, the wound has not healed, and there is still a small hole with a diameter of 3mm, though the depth is uncertain, which continues to secrete serous fluid.
The fluid is light yellow in color, and there is slight redness around the wound, but no swelling, fever, or pain.
A few months ago, during a shower, approximately 10cm of cotton thread was pulled out from the surgical site.
However, my father is very resistant to returning for a follow-up surgery to debride the wound.
I would like to ask the doctor if any foreign material inside could gradually be expelled through the serous fluid? Is the persistent non-healing of the wound due to the presence of foreign material? (Note: My father was a long-term smoker before becoming ill.)

Niming, 20~29 year old female. Ask Date: 2024/07/29

Dr. Chen Bingze reply Surgery

I'm sorry to hear that your father has undergone six surgeries.
Given his issues, it seems that the duodenal perforation he had was likely very difficult to suture.
The thread you mentioned is probably not a foreign body; it is more likely the suture material used for the subcutaneous fascia.
As for why the wound is not healing, I suspect that a drainage tube was specifically placed to allow some digestive fluid to drain out.
This was likely done to help your father recover.
Indeed, removing the drainage tube can sometimes hinder healing for certain individuals, but it is also necessary to place it.
I recommend discussing these concerns with the surgeon who operated on your father.

Reply Date: 2024/07/29

More Info

In your father's case, the ongoing issue with the abdominal wound that has not healed after multiple surgeries is concerning and warrants careful consideration. The presence of a small hole that continues to exude a yellowish fluid suggests that there may be an underlying issue that needs to be addressed. Given the history of multiple surgeries, including the potential for foreign bodies to be left behind, it is crucial to understand the implications of such a situation.

Foreign bodies in surgical wounds can lead to chronic inflammation, delayed healing, and even infection. In your father's case, the fact that he was able to pull out a 10 cm piece of cotton thread from the surgical site raises the possibility that there could be additional foreign material remaining in the wound. This could be a contributing factor to the wound's inability to heal properly. The body may attempt to expel foreign materials through the wound, but this process can be slow and may not always be effective, especially if the foreign body is large or deeply embedded.

The yellowish fluid you describe is likely serous fluid, which is a normal part of the healing process; however, if it persists, it could indicate that the body is trying to deal with an irritant or foreign body. The slight redness around the wound without significant swelling or fever is a positive sign, but it does not rule out the possibility of an underlying issue.

In terms of healing, if there is indeed a foreign body present, it is unlikely that the wound will heal completely until the foreign material is removed. The body may not be able to effectively eliminate larger or more complex foreign bodies on its own. Therefore, it is crucial for your father to consider returning to a healthcare provider for further evaluation. A thorough examination, possibly including imaging studies, may be necessary to determine the presence of any remaining foreign materials.

If your father is resistant to returning for surgical intervention, it may be helpful to discuss his concerns with a healthcare provider who can explain the risks of leaving the foreign body in place versus the benefits of surgical removal. Chronic non-healing wounds can lead to more serious complications, including infection, which could further complicate his health status, especially given his history of smoking and the associated risks.

In conclusion, while the body can sometimes expel foreign materials, it is not a reliable or safe method for ensuring complete healing. The best course of action would be to consult with a surgeon who can assess the situation and discuss the potential need for surgical intervention to remove any foreign bodies and promote proper healing of the wound. Encouraging your father to seek medical advice is essential for his recovery and overall health.

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