Medical Oncologist
CION Cancer Clinics
Wound problems after sacral and pelvic surgery | CION Cancer Clinics
Wound problems are one of the most common complications after sacrectomy and hemipelvectomy. The wound is large, sits where you lie and sit, and is often close to the back passage or in skin already treated with radiotherapy. Most problems are managed with dressings, antibiotics or a smaller second procedure. This page explains the types, what raises the risk, and which signs need a same-day call. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Why are wound problems so common after sacral and pelvic surgery?
- What kinds of wound problems happen?
- What raises the risk, and what does the team do about it?
- How is a wound problem usually managed?
- What do families believe about healing wounds?
- How do you care for the wound at home, and what can this page not tell you?
- Common questions about wound problems after pelvic surgery
The short answer
Why are wound problems so common after sacral and pelvic surgery?
Wound problems are one of the most common complications after sacrectomy and hemipelvectomy. The wound is large, it sits where you lie and sit, and it is close to the back passage, so it heals under more strain than most surgical wounds.
Why this area heals slowly
Removing a large piece of bone leaves an empty space under the skin where fluid can collect. The skin over the buttock or lower back has to stretch across that space. Many people have had radiotherapy to the area before surgery, which leaves the skin thinner and slower to heal. And lying on your back presses on the wound for hours at a time.
A wound problem does not mean the cancer operation itself went wrong. It is a known part of the risk your surgeon discusses before surgery.What can happen
What kinds of wound problems happen?
Your discharge summary may use the medical name. The plain meaning sits beside each one.
Wound breakdown
Part of the wound opens, at the skin or deeper. A report calls this dehiscence. Small openings often heal with regular dressings. Larger ones may need another operation to clean and close them.
Infection
Redness, heat, pus or a bad smell from the wound, often with fever. It may settle with antibiotics, or need a return to theatre to wash the area out.
If an implant is involved
- Harder to clear than a skin infection
- May need more than one washout
- Occasionally means removing the implant
Fluid collection
Fluid gathers in the space where the bone was. Clear fluid is called a seroma, and collected blood is a haematoma. Drains reduce this, but fluid can build up after they come out.
Skin flap problems
To close a large wound, a plastic surgeon may move a flap of skin and muscle from nearby. Sometimes the edge of the flap loses its blood supply and darkens. It may need trimming and time.
Spinal fluid leak
After sacrectomy, the covering around the nerves can leak clear, watery fluid through the wound, sometimes with a headache that is worse sitting up. Tell the team straight away.
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What cannot wait
Call your surgical team the same day, or go to the nearest emergency department, if there is fever or shivering, the wound starts to open, pus or a bad smell appears, redness is spreading, or clear watery fluid leaks from a sacrectomy wound. Say that you had pelvic bone surgery. Do not put turmeric, oils or powders on the wound first. They hide what the doctor needs to see and can bring in infection.
Who is more at risk
What raises the risk, and what does the team do about it?
Some things raise the chance of a wound problem, and a few can be improved before surgery.
Things that raise the risk
Radiotherapy to the area before the operation, diabetes that is not well controlled, smoking, being very underweight or very overweight, poor nutrition, a long operation and a wound close to the back passage all make wound trouble more likely. Steroid tablets and some cancer medicines can also slow healing. Do not stop any medicine on your own. Tell the team everything you take.
What the team may do to lower it
A plastic surgeon may close the wound with a flap of healthy tissue. Drains stop fluid collecting. A vacuum dressing may go over the closed wound. Antibiotics are given around the time of surgery. Some surgeons make a temporary stoma, an opening of the bowel on the tummy, so stool stays away from the wound while it heals.
What you can do before surgery
Stop smoking completely. Eat enough protein, such as dal, eggs, milk, paneer, fish or chicken, unless you have been told otherwise. Ask for a dietitian if you have lost weight. Keep blood sugar in the range your doctor sets. Ask whether a stoma is being considered, and why.
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If it happens
How is a wound problem usually managed?
Most wound problems are handled in steps, starting with the simplest. Not everyone goes through every step.
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The wound is examined and tested
A swab may be sent to find which germ is present. Blood tests check for infection. An ultrasound or CT scan shows whether fluid has collected deep inside.
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Dressings and antibiotics
Many problems settle with regular dressings and antibiotics matched to the swab result. You may be taught to care for the wound at home, or have a nurse visit.
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Draining or cleaning in theatre
A deep collection may need a drain placed using a scan, or a return to theatre to wash the area and remove dead tissue. Reports call this debridement.
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A vacuum dressing
A sealed foam dressing linked to a small pump draws fluid out and helps the wound close from the bottom up. It is changed every few days, and some people go home with it.
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Closing the gap
Once the wound is clean, it may heal on its own over time, or a plastic surgeon may close it with a skin graft or a flap.
Commonly believed
What do families believe about healing wounds?
"Turmeric or coconut oil will help the wound heal faster."
Anything put on a surgical wound can bring germs in and hide the early signs of infection. Use only what your nurse or surgeon has advised. If you want to use a home remedy, ask first, and never on an open or leaking wound.
"If the wound opens, the surgery has failed."
A wound that opens is a setback in healing, not a failure of the cancer operation. Most are managed with dressings, antibiotics or a smaller second procedure. It usually means a longer recovery, which is hard, but it is not the tumour coming back.
"Antibiotic tablets from the chemist will sort out a red wound."
Antibiotics taken without seeing the team can hide a deep infection that needs draining. The wrong one can also make the right one work less well later. Show the wound to your surgical team before starting anything.
Being straight with you
How do you care for the wound at home, and what can this page not tell you?
At home, the aim is to keep the wound clean, dry and free of pressure, and to notice change early. Your nurse will show you or a family member how before you leave.
Everyday wound care
Wash your hands before touching the dressing. Keep the area dry after bathing, and ask when a shower is allowed. Change position often, and use the cushion or mattress you were advised to use. After a bowel movement, clean from front to back, and change any dressing that gets soiled. Loose cotton clothing rubs the wound less.
What this page cannot tell you
It cannot tell you whether your wound is healing normally. Wounds after these operations look worse than most people expect, and the only way to judge one is to see it. It also cannot tell you your own risk. That depends on your operation, your earlier treatment and your health, which your surgeon knows.
Unsure whether something is normal? Send a clear photo to your team.Questions we are asked
Common questions about wound problems after pelvic surgery
How long does the wound take to heal after sacrectomy?
Longer than most surgical wounds. A wound that heals without trouble may close within some weeks, but one that opens or becomes infected can take many months. Your team will check it at each visit. Ask them what normal healing should look like for your wound at each stage.
Is some fluid from the wound normal?
A small amount of pale, blood-stained fluid in the first days is common, especially after drains come out. Fluid that increases, turns cloudy, smells, or is clear and watery after sacrectomy needs to be shown to your team the same day. Note the colour and how often the dressing soaks through.
Why was a stoma made?
Some surgeons make a temporary opening of the bowel onto the tummy, so stool does not reach a wound close to the back passage. It lowers the chance of infection while the wound heals. Many stomas made for this reason can be closed later. Ask your surgeon whether yours is meant to be temporary.
What is a vacuum dressing, and does it hurt?
It is a foam dressing sealed with film and joined by a tube to a small pump that gently draws out fluid. Most people feel a pulling sensation. Changing it can be uncomfortable, so pain relief may be given beforehand.
Will I need another operation for the wound?
Some people do. A deep infection, a large fluid collection or a wound that has opened widely often needs a return to theatre to clean it, and some need more than one. Smaller problems are usually managed with dressings and antibiotics. Your surgeon will explain which applies once the wound has been checked.
Can a wound infection affect the implant?
Yes. After a rebuild with metal or a bone graft, infection can reach the implant. It is harder to clear, may need several washouts and a long course of antibiotics, and occasionally means removing part of the implant. This is one reason the team reacts quickly to any sign of infection.
I have diabetes. Does that change things?
It raises the risk of infection and slow healing. Keeping blood sugar in the range your doctor sets, before and after surgery, is one of the most useful things you can do. Do not change your diabetes medicines on your own. Your physician and surgical team will adjust them together.
Who do I call if the wound changes after I go home?
Call the surgical team that did the operation first, because they know what the wound should look like. If you cannot reach them and there is fever, spreading redness or the wound is opening, go to the nearest emergency department with your discharge summary.
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- NICE — Surgical site infections: prevention and treatment (NG125)
- NHS — Pressure ulcers (pressure sores)
- American Cancer Society — Surgery for bone cancer
- Cancer Research UK — Bone cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Wound, Stitches and ScarsEveryday wound care after any cancer operationComplications and Red FlagsOther warning signs after surgery, and what to doSpinopelvic Reconstruction After SacrectomyThe implants a wound infection can reachBladder and Bowel Function After SacrectomyWhy bowel care and stomas matter for the wound
Talk to us
Worried about a wound after pelvic surgery?
Tell us what operation was done and what you are seeing. We will help you reach the right specialist. For fever, spreading redness or an opening wound, go to the nearest emergency department first.