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    Hospital stay after flap surgery

    How long after flap surgery is spent in the hospital before going home to finish recovering?

    #2
    It varies with the hospital, your insurance, and the provider. I worked in the VA system, and for the SCI/D Centers where flaps were done, the entire hospital stay, including pre-treatment of osteomyelitis with IV antibiotics, wound debridement surgery, 6 weeks of total bedrest (5 of which were on an air-fluidized bed like a Clinitron), then a 3 week sitting program was done on the same unit as an inpatient and we estimated 3-4 months for the whole stay for most patients.

    In the private sector, the best plastic surgeons still go with 6 weeks of total bedrest and use of the air-fluidized bed, but rarely does an insurance allow more than 7-10 of those days to be in an acute care hospital; instead either being discharged home or going to a nursing home for the remainder of the 6 weeks. Some insurances will then authorize an inpatient acute rehab stay for a 2-3 week sitting program, but many other insurances will not and you must do the sitting program on your own at a nursing home or your own home.

    (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.

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      #3
      Originally posted by SCI-Nurse View Post
      It varies with the hospital, your insurance, and the provider. I worked in the VA system, and for the SCI/D Centers where flaps were done, the entire hospital stay, including pre-treatment of osteomyelitis with IV antibiotics, wound debridement surgery, 6 weeks of total bedrest (5 of which were on an air-fluidized bed like a Clinitron), then a 3 week sitting program was done on the same unit as an inpatient and we estimated 3-4 months for the whole stay for most patients.

      In the private sector, the best plastic surgeons still go with 6 weeks of total bedrest and use of the air-fluidized bed, but rarely does an insurance allow more than 7-10 of those days to be in an acute care hospital; instead either being discharged home or going to a nursing home for the remainder of the 6 weeks. Some insurances will then authorize an inpatient acute rehab stay for a 2-3 week sitting program, but many other insurances will not and you must do the sitting program on your own at a nursing home or your own home.

      (KLD)
      Thanks for your reply. When I saw the plastic surgeon he said 1-2 weeks in the hospital and atleast 4 more weeks at home. Trying to get it scheduled with the office and they said it was an out patient procedure and I would be going home the same day. I need to talk to the office again.

      Comment


      • SCI-Nurse
        SCI-Nurse commented
        Editing a comment
        Even Medicaid in my state allows 10 days stay in the acute care hospital for a flap. You would not be able to sit up long enough to go to work until the very end of your 3 week sitting program as well. (KLD)

      • HACKNSACK44
        HACKNSACK44 commented
        Editing a comment
        I have workers comp and they will cover whatever the dr orders. I'm going to talk to the drs office again.

      #4
      Here is a typical sitting program which assumes the program goes as planned:

      https://www.carecure.net/forum/sci-c...09#post2920209

      (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


        #5
        Originally posted by SCI-Nurse View Post
        6 weeks of total bedrest (5 of which were on an air-fluidized bed like a Clinitron)(KLD)
        I just finished my 4th week in a an air-fluidized bed. What kind of bed did they use after week 5?

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        • SCI-Nurse
          SCI-Nurse commented
          Editing a comment
          After week 5, it everything looks good, we went to either a LAL (low air loss) mattress or a fluid immersion simulation mattress (like the Dolphin) for the remainder of the hospitalization, and for the first 2-3 months after discharge home. (KLD)

        #6
        That is determined by your surgeon and care team. It depends on their protocol and how your skin looks.
        ckf
        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


          #7
          Originally posted by SCI-Nurse View Post
          That is determined by your surgeon and care team. It depends on their protocol and how your skin looks.
          ckf
          Thanks

          Comment


            #8
            I'm 12 weeks post flap surgery. I have a 1cmx1cm opening at the bottom of the incision that hasn't healed. We are packing it with Iodoform with no change to it. I'm still using a air-fluidized bed. Any suggestions on what to do/try?
            Attached Files

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              #9
              I appreciate the picture and measurements you gave. However, I have no idea what the drainage is like, which makes recommendations difficult. Also, what, if anything have you tried prior to this. And how long have you been packing it? What does your care team recommend? Sorry for the questions- just need more information.

              Also, just so you know- I tried to answer this several times over the weekend but our internet was wacky. My apologies!

              ckf
              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


                #10
                Originally posted by SCI-Nurse View Post
                I appreciate the picture and measurements you gave. However, I have no idea what the drainage is like, which makes recommendations difficult. Also, what, if anything have you tried prior to this. And how long have you been packing it? What does your care team recommend? Sorry for the questions- just need more information.

                Also, just so you know- I tried to answer this several times over the weekend but our internet was wacky. My apologies!

                ckf
                Thanks for the reply. I saw my plastic surgeon today and he debrided it and stitched it closed. Hopefully that will work.

                Comment


                  #11
                  Did they ensure you don't have an abscess under the wound. I went in for a flap that never healed completely and they did a second with same results. Went in the hosp again. I refused to be released until the did a catscan or MRI to ensure all was good underneath the wound. They insisted with all the antibiotics taken, there was no chance of there being an abscess there but would do one anyway. Sure enough, there was an abscess that required another tow weeks in hosp with a drain. After it was determined the abscesses was gone, I healed up and am still good after 6 years post surgery.

                  Comment


                    #12
                    Originally posted by Patrick Madsen View Post
                    Did they ensure you don't have an abscess under thcomp wound. I went in for a flap that never healed completely and they did a second with same results. Went in the hosp again. I refused to be released until the did a catscan or MRI to ensure all was good underneath the wound. They insisted with all the antibiotics taken, there was no chance of there being an abscess there but would do one anyway. Sure enough, there was an abscess that required another tow weeks in hosp with a drain. After it was determined the abscesses was gone, I healed up and am still good after 6 years post surgery.
                    They didn't say anything about that being a possibility. If it doesn't heal up in a couple weeks I will discuss it with them. Did you have any other signs/symptoms of an abscess besides it not healing completely?

                    Comment


                      #13
                      Yeah, my blood pressure went really low. Like 40 which sent me to the ER. Basically though, I think it was the wound wasn't closing fully after such a long time.

                      Comment


                        #14
                        Originally posted by Patrick Madsen View Post
                        Yeah, my blood pressure went really low. Like 40 which sent me to the ER. Basically though, I think it was the wound wasn't closing fully after such a long time.
                        I will definitely keep that in mind. Thanks

                        Comment


                          #15
                          Keep us posted on how you are doing.

                          ckf
                          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.

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