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So are the "scabs" really necrosis? Confused...

So are the "scabs" really necrosis? Confused...

Postby so_ready » Sun May 06, 2007 8:23 pm

Sorry for all of the questions. I'm a bit confused about what's what. :oops:

So are the thick, dark scabs along the incision really necrosis and not just plain old scabs? Or do those scabs falling off, along with tension, cause dehiscence?

For example, the same type of scabs have slowly fallen off my bellybutton revealing healthy, normal looking skin underneath. The few I have left are just kind of hanging there and the skin looks normal underneath. The same is true of the small areas where these type of scabs have fallen off the incisions under my breasts.

And what is the difference between partial thickness necrosis and full thickness necrosis? Is partial thickness basically superficial?

Any input would be greatly appreciated! I would like to be more informed before my next appointment. Oddly enough I have trouble finding information that is straight online.
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Postby TraceLynn » Sun May 06, 2007 9:23 pm

I can't answer your question about the partial thickness or full thickness, because I never experienced Necrosis. I thought I had it. If you look at my first PO pictures, I have these really black scabs on my incison line. Went to see my GP because I live three hours from my PS and he called them something I can't remember and told me to just put triple antibiotic on them along with a non sitck pad. After a few weeks, they were gone. My PS called them blisters from my skin being pulled too tight. It's normal to have some scab in the belly button and along the incison. It's just that, Scab. And it sounds like since yours is coming off naturally and you can see healthy skin underneath, that you are just experiencing the shedding of scab.

If you will look at some of the pictures from some of the ladies who have already had their sx, you can see the dark scab on EVERYONE. Have you had your first PO appt with your PS? If you are worried about it, if you have an area you are concerned with, ask your PS. He'll know if there is anything to be concerned with.

Sounds to me like you are not experiencing necrosis.

Hope this helps.
T.
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Postby Dr.JLo » Mon May 07, 2007 2:02 am

Necrosis is poor skin healing or skin loss due to tension, low blood flow, smoking, or infection. It can take many forms. Superficial or partial thickness necrosis often heals with no intervention. Such would be the case where the epidermis is lost, falls off, and beneath it is healthy pink dermis.

Full thickness necrosis can involve the skin and fat layers, all the way down to the muscle layer and require months of care. Any and every combination of the above can and do occur.

"Scabs" are not a normal part of the healing process when the skin is neatly incised with a scalpel, which I'm sure your doc did.

A "scab" would be a normal part of say a scrape or a burn, where the skin is damaged or removed.

"Scabs" that occur along a nice neat scalpel incision are not usual, and come from another cause. Usually it's necrosis.

Necrosis occurs very predictable locations after TT: above the pubic area and around the BB. These are areas prone to low blood flow plus high tension. If you go through the necrosis threads from months and years back, you will see this commonality. Germaine and Hummergirl24 come to mind.

The diagnosis and care of necrosis can only be made by your PS, who is uniquely qualified to make your treatment recommendations.

Other conditions that can mimic necrosis are tape reactions (blisters), suture reactions, and rubbing from the garment to name a few.

Hope this helps,

John LoMonaco, M.D., F.A.C.S.
Houston, Texas

www.DrLoMonaco.com
www.BodyLiftHouston.com
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Postby maggie07 » Mon May 07, 2007 5:21 am

Thank you DrJLo, I have an opening and exactly in the area you said. My Dr does see me once a week, we are at the stage of packing it twice a day, but no ointment is used or antibiotic. It doesn't hurt, it's just scary. It is deep and wide. My hubby packs it for me thankd God for him, then we put tape on it and pull it tight to hopefuly keep it from opening more. I try to be very carful in my activities which right now is not much. I feel like its pulling and more pressure when I sit straight up or when I get in and out of a car.

Approx how long does it take to heal??? Dr.JLo can you answer that question please??? When it does heal, how will it look????
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Postby so_ready » Mon May 07, 2007 6:34 am

Thanks for taking the time to break that down. It was very helpful! It sounds like what I have then is the superficial type of necrosis and if I'm understanding you correctly, the scabs themselves are the dead tissue. Crossing my fingers and hoping that this is as bad as it will get. I don't have any deep wounds or anything that I could pack even if I wanted to, just a "divet" that's not too pretty where the scab came off. It looks like pink, healthy skin though. Thanks again! I'll be following up with my PS this week.

TraceLynn, I have had my first PO with my PS. All patients are seen weekly for the first several weeks so that he can monitor healing. I will see him again this week. Thank you for your reply!
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What I think

Postby nickyfourfatima » Mon May 07, 2007 7:27 am

Hi

I had scabs on my TT incision and I took it as a sign of a healing process. A good process. They were neat scabs and fell off with time. I had two spots where scabs were just hanging there so I pulled/tugged at it and WOW!big mistake for at those spots the scab did not fall off and it healed much later with a wider scar there. So don't do that. Someone on this board said its not necrosis. My belly button did not have a scab though. Nor my breasts (areola incision). I am 2 months out and all scabs gone, the scar closed and dark on its way to fading.

GOOD LUCK
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Postby germaine94514 » Mon May 07, 2007 3:59 pm

Looks like Dr. JLo answered that one. I'm glad you are back on the boards :D .
Germaine

Lipo 7/ 26/05 and 1/21/06
TT 9/21/06
Scar revisions from necrosis 4/3/07, 1/8/08
Necrosis free and had second stage of revision. Still have one more too go.
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