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David's sacral flap

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    David's sacral flap

    Hi Everyone,
    I had written about David having the flap surgery done on his sacrum after the surgeon removed the osteomyelitis on the small area of his tail bone. The surgery was done on December 3rd and he was in the hospital a little over 2 weeks before he came home. The flap looked great and it was amazing to see the area that had a hole and then to see it gone. If the stitches were not there, you would have a hard time knowing anything was done. Anyway, my question is this. The stitches have been in since the surgery on the 3rd, so that makes it just shy of 4 weeks that they are in. I see that the skin appears to be pulling now and around some of the sutures it appears to be a bit open. One even has a tiny bit of blood around it at the end of the suture. The home care nurse said it looks fine but I was just wondering why it did that. David goes back to the surgeon this Thursday morning and I wonder if the stitches will come out then. I know with a person with bad circulation as in sci that the sutures have to stay in longer. Just wondering what to expect and would appreciate any information from someone who knows about this. Dave tells me I worry too much but I can't help it.
    DavesMom, Diane

    The surgeon will decide if the stitches can come out and it certainly sounds as though some of them may be ready to. A little bit of blood around the stitch is nothing to worry about - it is normal. The stitches are pulling as the wound inside heals - that is ok.

    I would ask the surgeon his take on sitting. Generally we wait 4-6 weeks (more commonly 6 weeks) before we even contemplate having a patient sit. And then we do it VERY (and I do mean VERY) slowly.... like 15 minutes at a time, starting with once a day and then increasing it over a period of time. Each time we have someone sit, we thoroughly check their skin, make sure that there are no problems. Increasing time in sitting comes about every 24-48 hours. Sitting for a bowel program should really be the last thing that happens unless you have some super duper shower commode chair that I don't know anything about.

    Also make sure that the cushion he is using is the right one for him now that he has had the repair. I would strongly encourage you to get an appointment with a seating clinic or PT to pressure map David's skin and then determine the appropriate cushion to help relieve the pressure. Also, make sure that he does his weight shifts religously and that his diet stay s well balanced and a little high in protein.

    Good luck and let us know what the doc says.

    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.


      Thanks CKF for the response. As it turns out, David's appointment was changed to January 10 th so we will have to wait til then to see if the stitches come out. The home nurse came yesterday and she said it looks good. I feel better after your comment about the little bit of blood. I can see the stitches really pulling. Looks like one even popped. Will keep you posted and thanks again.