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Thread: Flap Surgery Coming -- advice sought

  1. #1

    Flap Surgery Coming -- advice sought

    Our 33 y.o. complete T-5/6 son (2013 injury) has been at acute LTC hospital for 6 wks; told today that wound has plateaued and that "flap surgery" requisite. We'll obviously get a second opinion (might hyperbaric be an alternative approach???), but want to be prepared to support the 4+ weeks' post-op "supine-on-one's-back" Clinitron experience.

    I have no idea how one maintains a positive demeanor during this type of experience. Anyone with personal experience out there who would share?

    Chap-Matt

  2. #2
    What level is he? Can he use a laptop? I would have gone nuts without TV and computer. I had a flap surgery almost exactly 4 years ago.

  3. #3
    Access to TV and laptop/tablet is a must. Someone to talk to helps as well... especially pretty women.

    I had my flap surgery 4 years ago and after a few months of bedrest, I was up again. Unfortunately, I had some other breakdowns and various other problems which has put me into an extended bedrest of nearly 3 years. Gotta keep the mind active and with his level, I'd advise upper body exercise/weights provided it doesn't cause spasms that might open up the stitches. An idle mind is the gateway to anger and insanity, make sure he stays busy doing something.

  4. #4
    My husband was home in a low air loss bed for a month until he could start inpatient rehabilitation. TV, video game console, Netflix, computer would occupy time and keep his mind active. Headphones to block out any motor noises from the bed. Arm weights or Theraband will help keep his upper body from getting too weak.

    For you, make sure you rest, try to maintain a regular sleep-wake cycle and eat a healthy diet. Get out of the house to visit with neighbors and don't be hesitant to ask for help. If you don't get mail delivered to the door, contact the post office to make arrangements. Keep up with paying bills on -time.
    There is always someone on Care Cure to lend support. Feel free to PM me if you want to vent.
    The one good thing about time is that it passes.

  5. #5

  6. #6
    I'm just home after spending 21 weeks total, since May, from a flap surgery that failed followed by a full roational flap then another three weeks in the clinitron after developing sepsis from an abscess they didn't know about surrounding the flap.

    After a couple of weeks, one just gets into the routine of the 24/7 floating in the bed. I didn't want visitors except my wife and family. I'm there to heal, not visit. The odd friend I'd let stop by. I spent most of the time either on my iPad, watching tv or sleeping and healing. I also brought in a small ukulele to play while laying on my back.

    Maintaining a positive attitude is either you have it or you don't. There were days when I've said I'd rather be dead than go thru this again but usually by the evening or next day I was back to my normal positive self. We usually don't have a choice on what happens to us but we do have a choice on how we handle it. I came out stronger mentally than I went in.

    3-5 weeks in a clinitron is short for flap surgery. The normal is 6 to 8 weeks, depending if it was infected before surgery, followed by two weeks gradually getting up for longer periods of time. He will be really weak at first but should rebound pretty quick. The main thing is to take it as easy as he can when first out. The flap is like like baby skin and will tear and reopen very easily. The first flap I was back in the gym as soon as I could use a sliding board. It may have been too quick and should have waited. The doc said I didn't do anything wrong; sometimes flaps just fail. This time around, I'm taking it slower. I came home with a picc line for IV antibiotics so have just been doing some stretches with the rubber cords and ribbons, standing in my stander and very light weights. The picc line came out yesterday and have been given the green light to get back with my trainer at the gym and back on the Handcycle. Today I used the Vitaglide for the first time and also the shoulder press to get ready to hit the gym.

    The positive aspect of being in the bed that long is he is on the road to healing and getting life back to normal. Once it's over, it doesn't seem like it's been that long at all. After three weeks, it'll go quickly It's going take months to really get back to where he was before the wound but with hard work and caution doing transfers etc., he should be okay. I'm glad he's having done if it's needed as prolonging it will eventually lead to it becoming infected with sepsis which travels fast and kills quickly. My initial flap was going to be a simple sew up surgery. Two days before the surgery, sepsis set in and traveled up towards may femeroal artery. Needing to clean all that out made the surgery much more difficult and my stay in the hospital. and assisted living that much longer.

    Good luck to your son. I hope he decides to join our forum. It'd help him immensely. Please keep us informed on how he and you are doing. This will get better.

    There's another thread you may want to read regarding one who refuses to do a flap: http://sci.rutgers.edu/forum/showthr...ing-well/page3
    Last edited by Patrick Madsen; 02-26-2017 at 02:21 AM.

  7. #7
    As to one of the first questions asked, hyperbaric oxygen is probably not an option for your son. Healing a Grade III or IV pressure ulcer is difficult at best and impossible at worst. You are probably looking at many months of treatment versus a shorter term with surgery. Also, there is no way of truly knowing what is going on underneath the surface without actually seeing it. Getting a second opinion is a good idea. I recommend it when there is a major procedure that is being looked at.

    All of the suggestions above are great ones. I think that they should come from those who have experienced this problem versus me.

    ckf

  8. #8
    Please look into Flowable Matrix. I've written on here before about it. I spent 6 months with wound vac. Didn't help. Got the flowable matrix done. In 3 weeks I was healed. Its been 5 months since and I am living normally.
    If he gets stuck in bed, PT and exercise are a must. Lots of protein to heal.

  9. #9
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    I'm a 46 year old C7 complete 23 years post injury. I've had 3 flap surgeries in the past ten years. I can tell you from experience that if the wound is a stage 3 or 4, surgery is really the only answer. As has been mentioned before, it's good to have it done as soon as possible. If you wait too long, its going to get infected and then it makes the whole process much longer and more difficult. Two of the three sores I had went septic and I had to get the infection cleared up before I could do anything with the sore itself. I went into septic shock in on instance and that almost ended it for me.

    None of the other treatments will get you where you want to be at this point. The key to the whole recovery is to prepare everyone for what's coming. Know going in that it will be 6-8 weeks of 24/7 bed rest and then another 2 weeks of a sitting protocol to gradually get him back up in his chair and moving around again. If they are telling you anything less than that I'd be weary. You don't want to get ahead of yourself and try to do too much too soon. You'll just have wasted a lot of resources and be back where you started. Find things to do. I preferred reading/listening to books and working on a computer. I even took a few online classes. Do whatever he likes, just stay busy and don't get too idle. Nutrition is also key to the recovery. It's hard when you're laying around ll day not burning any energy but he'll need to take in large amounts of protein to heal the healing process. Drink protein shakes daily, at least, and keep the rest of the diet high in protein too. Realize that it's going to be difficult and unpleasant but the good part about the surgery is that you have a definitive goal whereas if you try to heal it up others ways it could drag out indefinitely.

    One of the most important keys to the recovery is being able to recover on a proper pressure relieving surface (e.g. Clinitron). My downfall throughout all of my issues is that I couldn't get my insurance provider to approve a Clinitron. I eventually found a used on online to use. This seems to be a recurring problem with a lot of patients in our situation. In order to help other people not have to go through some of the problems I've had due to lack of adequate equipment, I've started a non-profit charitable organization that acquires used pressure relieving surfaces of all types and, with the help of a specialized medical equipment supplier, refurbishes the equipment and donates it back out to needy patients who have an immediate need for it. That being said, if you ever have a need for a particular type of bed or overlay mattress, let me know and I can work with you to get you what you need. I'm a resource to try and help others out to get them healed up and back to their lives. I know what it's like to go through this and I want to try and make it as easy on others as I can. I've benefited from others generosity throughout my time and want to do what I can to repay that.

    I hope everything goes well. Let us know if you need anything. We're here to help.

  10. #10
    Senior Member djrolling's Avatar
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    I spent 6 months in bed trying to avoid flap surgery. Only to have to do the surgery. I cannot even remember the bed rest afterwards though I am sure I did the bed rest afterwards. All the suggestions are good. Heck I did not have the Internet for all practical purposes it was back in 1995 and I had access but it was nothing like it is now so he just has to focus on what this time in bed will give to him.

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