Skin Graft and anesthesia

Mavericksmom

Does anyone know if skin grafts can be done with local anesthesia?  My breast wounds aren't healing, surgery was early January 2019.  When I go for my next visit in July I am asking for something to be done, other than just "giving it time," and if I don't get satisfaction I am going to another plastic surgeon. Other than the surgery,(DIEP flap), and taking drains out, they have done literally nothing for me other than look at my breast, comment that it will take time to heal, tell me to wash with soap, no lotions and cover with non-adherent bandages.  Oh, and make another appointment for....

My veins are so bad they can't use contrast for scans. I'm not getting chemo, so no port. 

I thought I read somewhere that it can be done with local anesthesia, which I am completely ok with, but I can't remember where I read that. 

buttonsmachine

Have your Drs ever suggested using a wound vac to help with the healing? Those are very effective and would probably give you a better looking result than a skin graft. Maybe you can get an opinion from another PS, or ask to be referred to a wound care specialist.

To answer your original question though, my skin graft was done with general anesthesia, but it was very large.

Best wishes, and I hope you find some answers soon.

Mavericksmom

buttonsmachine, thank you for your comments! My wounds were due to being severely burned when I had radiation treatments for IDC in 2003. When I had DIEP reconstruction they said I might have some problems healing, but this was not what I expected.

I asked about seeing a wound care specialist but they told me that would not help. My plastic surgeon’s practice is all cancer related. I see him at a major cancer hospital so I’m sure he has seen patients like me before, but he doesn’t get it that this is my first experience with wounds like this. Actually I haven’t seen my doctor since February. With no warning, I was switched to a Physician Assistant. I don’t know who I will see in July, but I will ask to see the doctor in July!

I considered my wounds large, I havethree, two are small but the largest is about 3”X4” Because I never experienced this before I really don’t know if that is considered large or it just seems large to me. That is why I depend on people like you. I value your input!

They told me it just takes time, but I after five months I’m tired of waiting for something that seems like it will never happen!

My appointment isn’t until July. At this point I don’t care what they do as long as they fix this! I am so worried about getting an infection the way it looks now.

sbelizabeth

Mavericksmom, the suggestion for a wound vac is a great idea. I had one for a DIEP-related wound and it helped a lot. What also helped a lot was hyperbaric oxygen treatments. If your surgeon doesn't have a lot of experience with wound vacs or hyperbaric treatments he/she might brush off the ideas, but you'll have to be persistent. Ask WHY NOT.

Mavericksmom

Good to know! Thank you! I will specifically ask about wound vac. Both you and buttonsmachine mentioned that. I have no idea what that is. I have heard of hyperbaric oxygen treatments but not sure how they work either. I will research them!

I will ask my doctorabout them! I already decided to get a second opinion if I am not satisfied with my visit.

Meow13

Maverick, member macb04 has done hyperbaric oxygen treatments might want to message her.

Mavericksmom

Iwill try to contact her. I looked at YouTube wound VAC videos, but those look like deep wounds. My wounds are shallow, skin is not covering them. Someone posted on the board that radiation wounds heal from the circumference inward, not from layers under growing up, if that makes sense.

I’m headed to work so I will contact macb04 after work.

Thank you to everyone who posted here

helenlouise

Hi marvarics mom,

I can imagine how frustrated you are, not to mention uncomfortable. I am sorry this has happened to you.

I have a wound from a surgical biopsy that is refusing to heal because of the radiation, chemo, surgery and skin Mets. My wound is 8 weeks old tomorrow and I dislike it very much. Currently 2 x 1.5 cm, 1 cm deep but it has undermined and I have 1 cm of tunneling. Everyone tells me it is not large and I appreciate it isn’t. Wound nurses deal with large open stomach wounds of many centimeters. I understand that my chest wall is compromised and my RO has given me a referral to a plastic surgeon but my surgeon agrees more surgery on this area would be risky.

I had a prevena negative pressure dressing (vac dressing) a day or two after the biopsy because of the amount of exudate. That was on over Easter. Then I went with a normal dressing but in the last week I have had an Activac dressing put on. Similar to the prevena but more appropriate now that the wound has opened up (since stitches were fully removed). All doctors tell me this will take a long while to heal. I am expecting months more not weeks. The nurses tell me they will be able to tell in a couple of weeks if the vac is helping. I have my fingers and torscrossed this will work. The vac is inconvenient because it’s noisy and requires the dressing to be changed by nurses every couple of days but I didn’t like changing a regular dressing up to three times a day either. The vac keeps the correct amount of moisture in the wound to encourage the healing. They also use a special sponge material to pack the wound and loads of dressing to keep it sterile.

Skin graft a big operation and a risk I don’t want to have to take unless there is no option. I see my MO this week so I will get his take on it. I trust him and he really is my medical team leader, so his opinion will be valued.

It sounds like your wound is substantial and persistent. I would imagine any skin graft wouldn’t be a minor procedure and unlikely to be done under local anesthesia.

I wish you good luck. Xx