How does it look to you? Where am I at in this necrosis battle? (photo)

Hi brodybret,I'm sorry to see your wounds are healing slowly.  It appears that your wounds will need continued care.  I usually see my patients every 2-3 days until i'm confident that things will heal well.  Please continue to see your surgeon and follow their instructions.  I'm sure you will do fine.Best,Dr. B

Hello:Necrosis of the abdominoplasty flap is a well recognized problem. Unfortunately, it happens from time to time and everyone is sorry for this outcome, even those that had nothing to do with it. Fortunately, After the wound is debrided, it usually heals in with a well vascularized scar which can be revised in the office under local anesthesia, if necessary. Sometimes, it can be closed primarily.  It will screw up your social calendar and sometimes increase your time away from work and fun. But hang in there. Stick with your plastic surgeon who has a vested interest in your improvement.  It/you will get better in the end. 

Dear brodybret,this type of wound is not uncommon after tummy tuck. It is usually caused by poor blood flow. I would suggest you to consult your plastic surgeon, follow your surgeon's instructions and keep your wound clean and covered. It can take few weeks or months for wound to fully heal. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

It appears the area that is very red is trying to establish more blood vessels to repair the necrotic area.  You have some mild area of skin necrosis which should be cleansed and debrided.  The area of partial necrosis may develop some fat necrosis which will cause the tissues to harden.  Time will be the determining factor.  The tissues will define what's viable to what is not.  You should continue to use silvadene as well as have your doctor trim the necrotic tissue.  Waiting for the necrotic tissue to fall off will delay healing.  Hope this helps.  Dr. Chu

is the best management at this time as you are trying to make sure all viable tissue survives.  What can you expect?  Eventually the scabs will fall off and if significant tissue damage has occurred, that will have to be debrided during your weekly visits as all dead tissue must be gone before real healing starts.  The size of your defect will be determined by just how must tissue is necrotic.  Wound care continues and eventually the wound starts shrinking and filling in and it heals over time.  So do things only when indicated... and some docs use wound VAC's to expedite the healing process but it usually adds cost unless covered by insurance so you can go without if you are patient.