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    Flap Surgery Incision

    Hi again from Indiana! I just had flap surgery on June 1st and I have probably a stupid question but unless I ask it my anxiety will just keep harping on it. Everything is going great, I’m recovering at home in an air fluidized bed and have been off of it (not sitting at all), all stitching is still holding and in place, no redness, swelling has gone down…however, my incision line is so scabby! Is this pretty common or does it just depend on the person? This is the first time I’ve been actually able to see a surgery site that I’ve had so if I’ve done this before with prior surgeries I had no idea. Someone ease my mind so I stop driving my husband nuts haha please and thank you!

    #2
    Scabbing around the sutures is normal. We applied triple antibiotic ointment to the incision (check with the surgeon on this) which softened the scabs and allowed them to be gently wipe off. Don't get freaked out about them. It sound like things are going well!

    (KLD)
    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.

    Comment


      #3
      Originally posted by SCI-Nurse View Post
      Scabbing around the sutures is normal. We applied triple antibiotic ointment to the incision (check with the surgeon on this) which softened the scabs and allowed them to be gently wipe off. Don't get freaked out about them. It sound like things are going well!

      (KLD)
      Thank you for responding so quickly! I know I’m barely over a week out from surgery but that’s one week done & over with! I asked our surgeon about every question in the book before & after surgery but never thought to ask this one….definitely eases my mind and I will check with him at my follow up Monday about the ointment! Thank you, and my annoyed Husband thanks you as well! Haha

      Comment


        #4
        Good to hear you are doing good.

        Comment


          #5
          i'd say if you are getting scabbing only 10 days after surgery you are doing real well. sounds like your healing a lot faster than most people

          Comment


            #6
            Just thought I would update I had my first follow up via ambulance to my surgeon and everything is healing great and holding and already softening up! Drain tube came out and stitches comes out in two weeks!

            Comment


              #7
              Originally posted by casey.n.brown. View Post
              Just thought I would update I had my first follow up via ambulance to my surgeon and everything is healing great and holding and already softening up! Drain tube came out and stitches comes out in two weeks!
              Great news!

              Comment


                #8
                Awesome ! Don’t rush the sitting program! CWO
                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.

                Comment


                • SLIQNES
                  SLIQNES commented
                  Editing a comment
                  My surgeon told me when I start the sitting program get in the wheelchair for 20. minutes. What happens after that what's the routine?

                #9
                Originally posted by SCI-Nurse View Post
                Awesome ! Don’t rush the sitting program! CWO
                I definitely will take it slow! He wants me down the full 6 weeks and that’s definitely what I intend to do. I do have a question if you’re able to answer this, my scabbing is starting to shrink down and flake off little by little but I have some pretty bad dry skin going on…anything safe to put on it, or should I just let it do it’s thing naturally?

                Comment


                • SLIQNES
                  SLIQNES commented
                  Editing a comment
                  My nurse has been applying Aquaphor to the site its been working well.

                #10
                Originally posted by casey.n.brown. View Post

                I definitely will take it slow! He wants me down the full 6 weeks and that’s definitely what I intend to do. I do have a question if you’re able to answer this, my scabbing is starting to shrink down and flake off little by little but I have some pretty bad dry skin going on…anything safe to put on it, or should I just let it do it’s thing naturally?
                I saw that you had flap surgery in 2008, did you do anything special (more weight shifts) or different wheelchair cushion to make sure your skin didn't breakdown again?

                Comment


                  #11
                  Originally posted by SLIQNES View Post

                  I saw that you had flap surgery in 2008, did you do anything special (more weight shifts) or different wheelchair cushion to make sure your skin didn't breakdown again?
                  yes I did have my first flap in 2008! That was only 4 years after my injury happened and was caused by not transferring properly because I wasn’t properly “taught” per day the correct and safest way to transfer in and out of my chair (lesson learned for sure!) that wound/sore was MUCH worse than the one I just had surgery on on June 1st, so that flap back in 2008 was much for extensive than this one was. But I do remember when I had that one done in 2008 after being COMPLETELY down for 6 weeks recovering, once my 6 weeks was up and I had that last follow up with my surgeon I had the green light to resume life as normal. In 2008 I had never heard of a sitting program and it was never mentioned to me during the entire flap process. But, I resumed life as normal after the 6 weeks and I had no issues at all and that flap healed wonderfully and I haven’t had a single issue since and still don’t. The only thing I changed was my doctor changed the cushion I was sitting on and ever since I have been on a 4” HIGH PROFILE roho cushion. I know a lot of people don’t like them and have balance issues on them but I’m T11/T12 paraplegic and I never had an issue with that and actually like the cushion. They’re expensive but worth it because I haven’t had an ounce of skin issues all this time until this most recent wound which was actually caused by a tissue crush injury when I was 37 weeks pregnant with our son back at the end of September that had no chance of healing because of it being a crush injury from slipping & falling. My surgeon told me all of this after my surgery I had a couple weeks ago once he got in there and seen the actual damage. So this most recent surgery was less invasive than the 2008 flap I had. But even when my surgeon seen the roho I was sitting on he even said that’s about the best cushion someone in my situation could be on! So my advice to you is definitely be more conscious of weight shifting once you’re all completely healed and have the green light to be up again, and research your cushions!

                  Comment


                  • SLIQNES
                    SLIQNES commented
                    Editing a comment
                    Thanks for the information, I had flap surgery May 4th then had skin graft June 8th. I was discharged to my house my wife is my caregiver I also have a nurse that comes every week. This is my first time having any issues with my skin (hopefully the last) the only instructions my surgeon gave me was after about 8 weeks I should get back in the wheelchair for just 20 minutes a day. I also have a high profile roho cushion so based on your information it seems like I'm heading in the right direction thanks again.

                  #12
                  Hi Casey
                  Glad you are doing well I still don’t have exact date for my flap but probably in the next month. I had messaged you about the bed. You are lucky to be in Indiana as group 3 beds are not available I’m Minnesota except in the hospital. I have been told even acute rehab will only have group 2.
                  I did talk to the owner of company you mentioned and he said 80% of areas in U.S. don’t have availability to rent a true air fluidized bed. I am going to pursue a good group 2 for when I get home.
                  I am still researching cushions and will try a Royo Quattro for a demo next week. Glad you are progressing well. Keep up the good work!

                  Comment


                    #13
                    The sitting program we used with much success was this:
                    Total bedrest with no sitting or flexion of the hip or knee at all for at least 6 weeks.
                    During week 5, slowly increase ROM exercises to get hip and knee to 90 degrees.
                    Day 1: sit 15 minutes. If possible, do interface computerized pressure studies on several cushions during that time.
                    Day 2: sit 15 minutes twice (at least 2 hours apart). If skin looks OK, repeat for Day 3.
                    Day 4: sit 30 minutes, twice (at least 2 hours apart). Do weight shifts every 10 minutes. If skin looks OK, repeat on day 5 and 6.
                    Day 7: sit 1 hour, twice (at least 2 hours apart), continuing to do every 10 min. weight shifts. If skin looks OK, repeat for day 8 and 9.
                    Day 10: sit 1.25 hours, twice (at least 2 hours apart), continuing to do every 10 min. weight shifts. If skin looks OK, repeat for day 11 and 12.
                    Day 13: sit 1.5 hours, twice (at least 2 hours apart), continuing to do every 10 min. weight shifts. If skin looks OK, repeat for day 14 and 15.
                    Day 16: sit 2 hours, continuing to do every 10 min. weight shifts. If skin looks OK, repeat for day 17 and 18. Use of a padded commode/shower chair for less than 30 min. can be included in one of these sitting sessions.
                    Day 19: sit 2.5 hours, twice (at least 2 hours apart), continuing to do every 10 min. weight shifts. If skin looks OK, repeat for day 20 and 21.
                    Day 22: sit 3.0 hours, twice (at least 2 hours apart), continuing to do every 10 min. weight shifts. If skin looks OK, repeat for day 23 and 24.
                    Day 25: sit 4.0 hours, twice (at least 2 hours apart), continuing to do every 10 min. weight shifts. If skin looks OK, repeat for day 26 and 27.
                    After that you can increase your sitting time by 1 hour once a day several times a week to 8 hours and keep it there for another several weeks before slowly progressing further.

                    (KLD)
                    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.

                    Comment


                      #14
                      By looking ok-visualize incision and area around the incision. If any pinkness, bogginess, pulling of incision or anything , back to bed until issue has resolved. Then start back at the beginning, we only used lift to get in and out of bed by PT once a day. Before starting the sitting program, rOM was done by PT or OT-if not enough range-then sitting program would not start until the goal was met. Many times, the sitting program was delayed a week or more, and many times, the increase of 15 minutes had to be restarted or not increased. A very slow process, not to be rushed or shorted. CWO
                      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.

                      Comment


                      • SLIQNES
                        SLIQNES commented
                        Editing a comment
                        Thanks very much
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