Does Quiescence Exist in Subcutaneous Abscesses? A Case of a 10-Year-Old Abdominoplasty Abscess

Abstract

Quiescence is the dormant state before the inevitable eruption of an infection. Several human diseases such as cancer may present with a relatively long period of inactivity, but soft tissue infections usually have a rapid progression. In this letter, we describe the rather uncommon clinical expression of an insidious subcutaneous abscess 10 years after abdominoplasty. It is our hope that this will be helpful in documenting this unique occurrence in the plastic surgery literature. A 61-year-old woman presented with tenderness in the infraumbilical region that was triggered after a blunt-force trauma (kick) in the abdomen 5 days before. Physical examination revealed normal periumbilical and abdominal scars (abdominoplasty sequelae), but the skin between the 2 scars was very firm and fixed to the underlying tissues, with associated localized inflammation (Figure 1). Apart from desquamation, no puncture point or other kind of wound was noted. The patient was a healthy woman and had no medical problems or treatment that could have compromised her immune response. Figure 1 Initial presentation. Note the skin deformation associated with desquamation and inflammation indicating an infectious subcutaneous collection. The patient had undergone an abdominoplasty 10 years before presentation that was complicated by a postoperative Staphylococcus aureus surgical site infection. The infection manifested an abscess of the infraumbilical region with no wound dehiscence; it was drained twice. No …