Is it necessary to have a Woundvac 4 weeks post Panniculectomy/Hernia Repair? (photos)

Please Help! (Photos w/scab & after PS cut off scab) I'm 46yo & have MS. My PS took drains out 1wk, cut off scab 3wks, & now @4wks wants to do wound vac. Isn't this too soon for something so invasive? My spouse changes gauze 2x daily & I air out too then he adds Rx silver antibiotic, I bath daily & I'm on Levoquin. I don't want to go thru 4wks changing a vac & my pubic hair/scab will be ripped off @ vac change since incision is 3" above pubic hairline. I've seen on YouTube how painful it is :( Opinions fast pls!

Doctor Answers 2

Panniculectomy problems

If that's really what the fat looks like under your skin, you need to have that fat, which is dead, debrided in the operating room.  A wound VAC does not debride tissue.  You apparently had distal flap necrosis of your skin flap, and are unfortunately now dealing with the repercussions.  These things happen sometimes.  The key now is to get any infected or dead tissue out of your body so you can really heal up as fast as possible.  Any future problems can be dealt with later.  

Houston Plastic Surgeon
5.0 out of 5 stars 32 reviews

Wound healing after panniculectomy

Sorry to hear about your panniculectomy healing.  A wound vac helps to expedite healing so that the wound closes faster.  However, all dead tissue needs to be removed prior to starting the wound vac.  If your plastic surgeon is recommending surgical debridement and then wound vac I would say go for it since it will make the wound heal  much faster.  Wound vac treatment in a clean wound would only have to be changed every week or so.  There is no harm in continuing with dressing changes as you have been doing but if debridement is needed and recommended by your plastic surgeon then this must be done.  After debridement, your wound will be deeper.  Because of this the wound vac would be recommended but it is not 100% needed to have the wound heal, it would just make the wound heal faster.  Again, the key is debridement.  If there is non-viable/dead tissue present, this tissue must be removed regardless of what type of dressing you decide to continue.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 reviews

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