Abdominal wall gossypiboma

A 71-year-old woman, one year following a fleur-de-lis abdominoplasty and incisional hernia repair, presented with two chronic, draining peri-umbilical sinuses. Her immediate postoperative course was complicated by a superficial surgical site infection with central skin breakdown that was treated with vacuum assisted closure (VAC). After the wound had closed completely, two midline sinus tracts developed. A CT scan demonstrated an 8 × 3 × 1.6 cm thick-walled collection along the anterior abdominal wall containing numerous air bubbles. Surgical debridement revealed a cavity containing an 8 × 3 × 1.6 cm block of well incorporated VAC foam. With the increasing clinical use of VAC wound therapy, this image serves as an important reminder to include gossypiboma in the differential diagnosis for patients with chronic wound problems who have previously received VAC treatment.