Cesarean incision problem

Patient

Q: Cesarean section of 35 years ago
On the incision a small pea hole has opened. I have had 2 procedures that produced old stitches not dissolved. I have just had a third procedure. A stitch was not found. the surgeon cleaned up the area. Now it is open again, bleeding slightly, periodically.
When it finally did heal, a small bubble formed, reddish. When we popped it it doesn't hurt anymore but now I have a small pea hole on the incision again. What can I do?
Should I see a surgeon or go back to my OB. My OB is wonderful.

Symptoms:  Small pea sized opening on a recent incision draining small amounts periodically
Doctor

A:   Hello,
Thanks for the query to askthedoctor.com for an opinion.

As described in the history that Cesarean section happened 35 years back, when non-absorbable suture were probably used for rectus closure and there might have been old undissolved stitches which may have pouted over the rectus and beneath the skin leading to granuloma formation. Similar thing may have happened after the second surgery when you experienced a granuloma formation and you popped it and now there is a hole in the cesarean scar which may be discharging serum or serosanguinous fluid.

It is suggested that you should visit your obstetrician for a review as this occurrence has been following a previous c-section. Ideally it has to be cleaned again and the subcutaneous tract has to be measured and if required the wound may have to be freshened and re-sutured for better healing simply because old scar wounds heal poorly.

I suggest your obstetrician because he has the moral responsibility towards the surgical intervention which he had done, if it hasn't healed for so long. Though the same procedure can be easily done by a surgeon as well.

I hope i have answered your query in detail,
Wishing you good health,
Regards

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