Is my necrotic wound healing well? Does it look like it needs another debridement? (photo)

Question

My routine: sanitize, apply ointment, and cover. My PS says no wound vac or vinegar gauze is necessary. No further treatment, except closure, is planned. Any thoughts? 1) Can this size wound close on its own? Or, 2) If stretched, won't my belly button be too far down? And, 3) Should I be worried about the protrusion from my belly button? 4) Does it look like it needs another debridement? 5) My abdomen is so swollen that my measurements are the same as before surgery. Will this all go down?

Darryl J. Blinski, MD · Answer

Yes over the next 3 months this open wound will heal. Than consider revision after another 6 months to allow softening of tissues...

Douglas Hargrave, MD · Answer

In spite of how bad things look at this point, I would expect this to heal up well and that your result will not be much affected. Once you have established a healing trend with this wound, (that will require more debridement for sure), then the wound should start to close down.  It will eventually close on its own, but it will probably heal faster if  your surgeon closes it secondarily.  The protrusion from your belly button and the generalized swelling that you have will subside as time passes.   Hang in there, better days are coming.Dr. Hargrave

Jourdan Gottlieb, MD · Answer

Sorry to read about your course. Easiest question--yes, I do think more debridement would be best. There is obviously non-viable tissue at the base of the wound--all the yellow material.Yes, this can close on its own, though it make take a couple of months. As I look at the series of posted pictures in previous postings, I suspect there is enough surviving skin that the navel will not be distorted as the main wound heals.  I can't really make out what looks abnormal about the navel, but I suspect it is swelling of healed skin.The abdominal swelling will probably not resolve until the wound has healed, but it will resolve. Obviously, you need to follow closely with your surgeon. If you don't concur with the recommendations, a second opinion may be helpful, though not necessarily easy to arrange. All the best.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question and photos. A personal exam and
consultation is always best.That said i recommend that you be examined by your surgeon. If you are not satisfied with your surgeon's treatment, I recommend getting a second opinion by a board certified plastic surgeon who has experience in wound care.  Based on your photos, it seems that more debridement is necessary to facilitate the healing.Be sure to consult a plastic surgeon who is certified by the
American Board of Plastic Surgery, experienced in your procedure, and who has
an excellent reputation in your community.

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