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Abdominal wound issues after Tram Flap Reconstruction

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Posted 7/24/2010 12:43 AM (GMT 0)
This is my first posting, other than to intro myself, but I am very concerned and need to ask if anyone has some advice they can offer.

 

I was diagnosed with DCIS Stage II in Feb 09, right mastectomy including a string of 13 lymph nodes (4 were positive) in Mar 09, chemo from Apr - Sept 09, radiation from Oct - Dec 09 and "official" remission" in Feb 2010. I had my Tram Flap surgery on June 15 and it went very well. The new breast is healing beautifully. Even in the hospital there was a 1 inch round purple spot (looked like a flat scab) the Plastic Surgeon said he wasn't pleased with (it was on the abdominal incision) and said he would keep his eye on it.

 

Well, the spot didn't get any better...in fact it got worse. I've been back to see the Plastic Surgeon every week since the surgery because of how bad the wound has gotten. We tried Silvadine ointment and that didn't work. Then we moved to Saline soaked gauze and that hasn't made it any better. Three days ago I started to notice a foul odor when we were changing the dressings (which we do twice a day), so the Dr brought me in again. He said he wants to "formally" address the wound...meaning scrape and debride the wound to clean it up, then apply a "wound vac" to help it heal up. There was also a hole that opened on the right side of the incision, that we've been stuffing with wicking to heal from the inside out. That has really helped and the hole has healed quite well to the point that the Dr says he will be able to stitch it closed when he goes in to clean up the other wound.

 

So now I'm scheduled to go in for day surgery on this coming Wednesday to have my wound dealt with and I'm not exactly happy about it. I'm very depressed about how long this is taking to heal, I'm upset about how it looks and smells and I'm not really sure what's gonna happen next either. My husband is very supportive but it's still on my mind all the time and so depressing to me.

 

Has anyone else had any experience with abdominal wound healing issues? Has anyone had any experience with wound vacs? I could really use some advice. Thanks to everyone in advance.

Jenyfer in SC

Posted 7/24/2010 2:38 AM (GMT 0)
I'm sorry that you've had such a rough time. I know someone who had this is a complication in a different type of surgery; he had the same procedure as the one your scheduled for, but it did work. It takes time and patience to heal; but it was the only and best way to deal with it.
prayers and good luck wishes,
Janice
Posted 7/24/2010 11:54 AM (GMT 0)
Thanks Janice. I'm hoping the wound vac works. I will keep everyone posted after my surgery next Wed on how things progress.
Posted 7/25/2010 10:53 PM (GMT 0)
fingers crossed and prayers for the very best outcome!
Janice
Posted 7/26/2010 4:12 PM (GMT 0)
Jenny, please go to the website I am giving you and read about contaminated sutures. I had this problem ten years ago and although they have been recalled they are still showing up. Talk to your plastic surgeon about the articles. Most doctor are still unaaware this happened because it was kept so quiet.

http://www.sfgate.com/cgi-bin/article.cgi?f=/examiner/archive/1999/02/22/NEWS5798.dtl&type=printable

http://www.geoffmetcalf.com/qa/21831.html

Ask questions if you need my answers. Mary K.
Posted 7/28/2010 11:13 PM (GMT 0)
UPDATE!!!  I had my day surgery this morning to "formally" clean up the wound (scrape and debride it), then either close it completely or put a wound vac on it.

 

While I do want the wound healed up, I was a little depressed about how long all this has been going on and I'd gotten in a cranky mood about it las week (a bit of a "oh poor me" attitude"). Thank goodness I went to a funeral mass with my best friend (her sister-in-law's mother) last Saturday and during the Mass I began to feel so guilty for the "pity party" I'd been throwing for myself. There are so many people who have way worse problems than mine, and I should not be carrying on the way I have been about my problem...I should be saying a prayer for other's who are worse. There sat my best friend's sister-in-law, who is going through chemo for Stage III breast cancer, her husband is an alcoholic and didn't show up for the funeral mass and she is sitting there burying her mother......YES, there are people who need my prayers and thoughts and I need to stop complaining!!

 

So, this morning my Plastic Surgeon says that his goal is to completely close up the wound, He said he thinks the problem was that my body "didn't like" the type of internal stitching material they used (I guess there are all kinds), which is why I had a couple of holes open up and it didn't heal well. I told him that I really didn't care if he ended up using the old fashioned black external stitches because it wasn't like I was planning a second career after retirement as a pole dancer.....he joked and said he did like to keep his patient's options open. LOL  When I woke up (if you call this awake because I'm high as a kite....but I swear I didn't inhale!) I was told he was able to close up he entire wound. I can't stand up straight, pick up more than 5 lbs and must sleep with pillows under my knees for the next 10 days. My husband said my Surgeon showed him a before and after pic on his camera and it looks good and tight. I'll get to see it in 24 hours when we change the dressing for the first time.

I'm excited!!!  I really hope this works.  I'll be following all the Doctor's orders, you can believe that! 

Posted 8/1/2010 8:32 PM (GMT 0)
Jeny, please let us know how you're doing..
good luck and good healing!
Janice
Posted 8/1/2010 10:59 PM (GMT 0)
Hey, Jen, don't beat yourself up about the "pity party." Geez, we could die of this darned disease, so I think we are entitled to a few pity parties along the way. The important thing is to have it and be done with it, as you did! Fingers crossed that this will be the surgery that "takes." I asked my PS if he could add a few sequins to my sutures... I like a little bling! Nothing doing. Ah, well. I'm a bit too old for pole dancing these days, anyway. Please keep us posted!

Hugs...
BEV
Posted 8/7/2010 3:42 PM (GMT 0)
Wow, you have been through the mill, haven't you. Prayers coming that all heals well now and you can get on with your life!!  Keep us informed how things are going, ok?

Don't overdo and take care!

Hugs,

Gail

Posted 8/8/2010 4:27 PM (GMT 0)
It has been eleven days since your surgery and I am eager to know how you are healing!!!! My thoughts and prayers are with you that you are much, much better. Hugs MK
Posted 2/8/2011 8:21 PM (GMT 0)
I hope that everything is better

 My mother has had an abdominal wound we have been treating for three years. The last surgery (this will be 4or5)   was to end all problems. However the wound is back after 7 days of recovery. We have not been able to get any more help, everyone just shruggs their shoulders and we have also been told, " it may be the cross we have to bear".  Her wound is the size of a quarter and about 1 inch deep and seeps fluid constantly.

 I don't really know what to ask, just to know what treatments were used to compare notes. Thanks

Posted 2/8/2011 8:59 PM (GMT 0)
To answer your question about the wound seeping fluid: this may be a sign of infection. As long as there is infection present the wound will not close. Has the doctor taken a culture of the fluid? That would tell him if it is infected and what bacteria is causing the infection. That determines what antibiotic to use. FK
Posted 2/9/2011 3:21 AM (GMT 0)
during the last surgery she admitted to two different hospitals, then to a rehab facility at the rehab facility they informed us she had mrsa and was getting proper tx. Scar tissue has nearly covered the whole area now, Doctors are unwilling to offer any suggestions. Due to prior medical conditions no one wants to tx.
Posted 2/9/2011 5:12 PM (GMT 0)
My father had a similar situation following open heart surgery. It took a total of four surgeries to get the hole to close after two years. The doctors in Florida had also given up, but my brother then brought him to Utah (where he lives) and found a new team of doctors who first retreated the mrsa with different antibiotics and got the wound to stop "weeping" and then did another big surgery to get the hole to close. That was a year and a half ago and it has remained closed. FK
Posted 10/8/2013 2:28 PM (GMT 0)
jennyj89,
Unbelieveable! Your story sounds near exactly like mine, DCIS Stage II, 14 nodes removed, 4 positive, though mine happened in 2002.
My incision site from the Tram Flap reconstruction has opened up, not once, not twice but three times now, in the last 9 years or so. While under initial chemo, I became diabetic, so I attributed the open, non-healing wound to the diabetes - and I did not want to hear it from my doctors, so I covered it up, applied 1st aid antibiotic creams and watched what I ate. By some miracle, it did close - but then opened up again a few years later. This time, I went to the plastic surgeon that did the Tram Flap reconstruction.
Same story as yours, Jenny. Last year, they debrided the wound, removing scar tissue, fat necrosis and any part of the Marlex mesh that was affected by the MRSA (which they tell me was "community born" - in other words, I introduced the infection, myself). The incision healed well, with the aid of a wound vac (read as torture device).

I would like to know how Jenny has done since, because less than a year went by and I again noticed my wound was going to open up again. So again, I went to the plastic surgeon before it opened. I do wish he had taken a sample of the fluid that I knew was going to be eventually seeping from through this "bubble", soon. To late, it opened up before he could attend to it. Plastic surgeon plans to clean the wound out - at their own surgical center. Praying there is not need for a wound vac. :(

Member - GMA, I have written down the websites for the information on the sutures. I hope that I can still access the article. I had feared that the mesh used in the procedure was a problem, as we are hearing so much about on TV (law offices looking for patients willing to sue someone).
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