Tummy tuck post op 21 days. Do I let small necrotic skin dry up or do I keep it moist to slough off? (Photos)

Question

My surgeon says to just clean with saline and apply bacitracin for now. I have heard that silvadene is good for necrotic skin. I want to know do I keep the wound moist or do I let it dry out? And is it safe to apply silvadene while it’s still closed or wait until it opens? Or are there any other suggestions as to care for it? (Non smoker, non diabetic, had six 1 hour sessions in hyperbaric chamber)

Beverly Friedlander, MD · Answer

Hi Thank you for your question and your photos.  I am sorry to hear of your problem.  There are many acceptable ways to treat wounds such as yours.  Both bacitracin and silvadene will provide the needed environment for healing, although some doctors do advocate  allowing the dark area to dry out at this point.  Follow your doctors instructions.   It will take time to heal, perhaps a few weeks, so be patient.Good Luck,Beverly Friedlander, MD

Douglas Taranow, DO, FACOS · Answer

Dear A Starr,Sorry you have experienced a known complication of abdominoplasty procedures.  The treatment for your black (necrotic) skin varies between practitioners.  Some like the allow it to dry and separate approach while others prefer Bacitracin/Silvadene/Enzymatic meds to dissolve the tissue.  I treat each case differently.  You will not harm your flap by using either the dry (no treatment) , Bacitracin or Silvadene approaches.  Best of luck with the continued healing and eventual revision procedure.Dr T

David E. Berman, MD (retired) · Answer

both approaches are correct so you should follow your plastic surgeons advice. These things happen, even with the best surgeons, so it is no one's fault - complications do happen. it is important to be very patient since this will take a lot of time to fully resolve. however, in the long run, your final result is likely to be excellent.david berman md

Tummy tuck post op 21 days. Do I let small necrotic skin dry up or do I keep it moist to slough off? (Photos)

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Tummy tuck post op 21 days. Do I let small necrotic skin dry up or do I keep it moist to slough off? (Photos)

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