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Posted by Delilah (Dee) on September 8, 2016, 4:57 amUser logged in as post
Edited by post on September 17, 2016, 11:08 am
Hi Dr. D, I have written you many times here lately. I have recently sent all my records and photos to your facility as my implant reconstruction has failed on radiated side. First large seroma, now after surgery to evacuate seroma with new implant placed, incision is not healing in a few spots,1 opening is about the size of a ball point pen tip, sites are draining some serous to sometimes cloudy fluid at mild to moderate amnt. At this point I have decided to come to your center for hoping eful hip flap corrective surgery, bilaterally. My question is:I am continually told I do not have infection as there is no erythema, edema, fevers,etc. Only unusual symptoms are I am normally extremely energetic and have been excessively fatigued with low temps 97.2-97.6 with weight loss, maybe 5-7lbs (I'm small at 111 lb so it's a lot of weight) but also just finished antibx a few days ago; now I'm wrapped in ACE around breasts and applying silvadene to incision per my PS. I know you said in prior post if mild infection is present it is still better to go ahead with autologous recon while implant still has tissue expanded. My worry is the drainage has been ongoing for a few wks now and I don't want to set up my surgery asap with your facility just to fly there and be told the issue needs to resolve first-ie implant needs to come out, area needs to rest/heal for a few months, then go forth with autologous recon? In case there actually is an infection. Sorry for long post, I am really struggling with this as it has been a very trying and scary situation and this stuff is way over my head knowledge wise. I am young, 39,usually very active and very healthy, non smoker, etc. So if you can advise-I have been discussing my situation with Liz at your facility but would like to know what you think is best in this case. Take implant out, get back on antibx and wait for some healing to occur or try to get first available spot at your center. Just want to minimize chances of flap loss/failure.
And one more important thing, my current PS has also said dong bilateral hip flaps at the same time is very risky for flap loss due to flaps being at risk of ischemia during surgical process, and also has said in his opinion that this is too difficult of a surgery to undergo all at once for patient safety and should be staged in 2 separate surgeries, 3 months apart. HELP!!
Thanks so much for all your time and advice, it is truly priceless.