Flap Alternatives

[Quad Kings]

From what I read here, and what my doctor tells me, flap surgeries have only about a 30-40% success rate. What are the other alternatives? Already tried wound VAC and had significant progress from stage 4 to stage 3 until it stopped closing. So why has it stalled out? And why can't they just stitch up the wound from inside out?

I have done whatever they said to do. It just won't close (after four months+). Recently tried two active air cushions, but the wound keeps getting damaged.

What else is there?

[smokey]

King, I think the percentages are around 50% or maybe a little higher if you have an experienced and skilled plastic surgeon do it. I had a small flap done in Nov. 2010 that failed 2 weeks after I got home in late Feb. 2011. The guy did a shitty job and refused to shave down the ischium. I went to another plastic surgeon in Nov. of 2011 who shaved down the ischium about 1/2cm and did the flap correctly, I believe and I am fine so far and there is more tissue or "padding" in that area now. I only had a small abrasion (1/4" in diameter) that was clean, shallow and not even draining but in a terrible spot right over the ischium. I stayed off it for a long time but it would not close up without surgery. So keep an open mind about a flap procedure, choose your surgeon carefully, stay off it if you can so it doesn't get worse, get proper nutrition (protein) and fluids. Good luck.....I know how it really sucks to be burdened with a butt sore.

[darty]

Originally Posted by Quad Kings

From what I read here, and what my doctor tells me, flap surgeries have only about a 30-40% success rate. What are the other alternatives? Already tried wound VAC and had significant progress from stage 4 to stage 3 until it stopped closing. So why has it stalled out? And why can't they just stitch up the wound from inside out?

I have done whatever they said to do. It just won't close (after four months+). Recently tried two active air cushions, but the wound keeps getting damaged.

What else is there?

I have been injured 31 years and have had similar problems. The vac has NEVER worked for me at any time. I have followed the wound clinic's advice exactly and have not had the best results. From what I have been told with a new wound your body rushes to try and heal it but after awhile your body will just stop healing and the wound will become chronic.

All they have offered me in the past is to debried it either in the clinic or during surgery to make the wound acute again and your body will once again try to heal it. I did get lucky and found a surgeon who was able to do a wound closure and just stitch it together for me 2 years ago and it's holding up but my fingers are crossed.

If you have infection it will not heal and if the bone is infected you have much larger problems. Sorry I really don't have an answer for you but maybe an explanation of what might be going on.

[wheeliecoach]

My husband was in hyperbaric therapy and had weekly debriedments...with this combo his is almost closed.

[lynnifer]

There's always electrical stimulation?

[Handsome Wheeler]

Originally Posted by Quad Kings

From what I read here, and what my doctor tells me, flap surgeries have only about a 30-40% success rate. What are the other alternatives? Already tried wound VAC and had significant progress from stage 4 to stage 3 until it stopped closing. So why has it stalled out? And why can't they just stitch up the wound from inside out?

I have done whatever they said to do. It just won't close (after four months+). Recently tried two active air cushions, but the wound keeps getting damaged.

What else is there?

I have had success with the vac. Does your nurse use stoma paste to secure the vac?Regardless of cushion,you need to shift your weight every 3-5 minutes. ABs don't sit for 15 minutes in one position. Are you able to do pressure relief?

[johnc1]

I'm going through a very similar situation. I've been down for 21 weeks this Sat with a stage 4 and osteo. I had a debreedment and have been on a wound vac & IV vanco. The healing seemed to have stalled so I really pushed the protien, Juven, arginane(sp). I saw the plastic surgeon last week and I'm finally in a position to have a flap surgery. My surgery is scheduled for March 27th. My wound care nurse was here this morning and said it is now healing so fast it may be closed in 2 or 3 weeks. Now what?

[Handsome Wheeler]

Originally Posted by darty

I have been injured 31 years and have had similar problems. The vac has NEVER worked for me at any time. I have followed the wound clinic's advice exactly and have not had the best results. From what I have been told with a new wound your body rushes to try and heal it but after awhile your body will just stop healing and the wound will become chronic.

All they have offered me in the past is to debried it either in the clinic or during surgery to make the wound acute again and your body will once again try to heal it. I did get lucky and found a surgeon who was able to do a wound closure and just stitch it together for me 2 years ago and it's holding up but my fingers are crossed.

If you have infection it will not heal and if the bone is infected you have much larger problems. Sorry I really don't have an answer for you but maybe an explanation of what might be going on.

Where is your wound? Stoma paste gives a better seal to those curved areas around scrotum and ischium.
You are lucky you found a surgeon that would stitch it together.If it's held for 2 yrs,the reason for failure would be pressure or shearing. You also avoided compromising perfectly good tissue over a much larger area with a flap.

[Handsome Wheeler]

Originally Posted by Quad Kings

From what I read here, and what my doctor tells me, flap surgeries have only about a 30-40% success rate. What are the other alternatives? Already tried wound VAC and had significant progress from stage 4 to stage 3 until it stopped closing. So why has it stalled out? And why can't they just stitch up the wound from inside out?

I have done whatever they said to do. It just won't close (after four months+). Recently tried two active air cushions, but the wound keeps getting damaged.

What else is there?

I experienced the same problem 5 yrs ago. Wound healing with vac slowed to a crawl.I stopped using it for a year. I then returned to the vac and wound closed within a month. Sometimes wound just need a jump start.

[Handsome Wheeler]

Originally Posted by johnc1

I'm going through a very similar situation. I've been down for 21 weeks this Sat with a stage 4 and osteo. I had a debreedment and have been on a wound vac & IV vanco. The healing seemed to have stalled so I really pushed the protien, Juven, arginane(sp). I saw the plastic surgeon last week and I'm finally in a position to have a flap surgery. My surgery is scheduled for March 27th. My wound care nurse was here this morning and said it is now healing so fast it may be closed in 2 or 3 weeks. Now what?

I'm a believer in Juven as I'm convinced it helped me. Local VA Hospital gives it to all patients with wounds.