nec fasc...

Well, it seems that I am catching up on some blogging that has been missed thus far this week. For those that are interested in what I see on a regular daily basis during the course of this plastic surgery rotation...
Here is a case of a lady who fell at home off the steps of her back porch. She scratched her leg in the process and developed necrotizing fasciitis. She underwent radical debridement of her wound and then got a medial gastroc flap and STSG [split thickness skin graft]. Two days later, the rest of her wound was covered with a synthetic skin-like substance: Integra. A wound VAC was placed and the wound was dressed. She is to undergo dressings changes of the wound every 7 days. As it turns out, I snagged a pic or two of the wound at 14 days out, and the attached pic is waht it looked like. The integra looks like it has taken well [distal portion] but the STSG looks like it is struggling to take onto the medial gastrocnemous flap. EIther way, it is amazing what is done these days in wound care for people that really need it. The poor lady is in a great deal of pain and the meds that she is getting for this issue really don't seem to have much of ain impact on her... and after looking at the wound, I can only imagine. Hopefully her healing process will progress rapidly and her pain will soon diminish... but I can only watchfully wait and pray.

-Garry