Urgent help needed with a necrosis question.

Dr. Dean Kane Q & A. 7K0A0116 Q.  A relative had facelift surgery which yielded lots of necrosis on both sides. A couple hematomas were drained. It is now 2 weeks after surgery. She still has some oozing and she’s lost a lot of hair. The doctor prescribed Silvadene a couple days ago and will debride with Santyl on Monday. She is very concerned about losing more hair. Is the debridement the best route? Will all the rest of hair in the debrided area be lost (or any surrounding areas)? Will it ever grow in those areas? A. ​So sorry for your relative’s troubles! ​ ​There are many factors that lead to necrosis following any surgery but facelifts in particular. ​ ​Lack of circulation to the skin flap is what causes the edges of the skin to die. As this is occuring, gentle debridement (there are many methods) of non-vital tissues is best to control the potential for infection from bacteria in the skin and hair follicles. Antiseptics and moist dressings will also improve the environment to reduce infection and desiccation or dryness. ​ ​This is a difficult time for your relative. He / she will need comforting and support and know that things will improve over time even if it feels and looks worse right now. ​ ​Depending on the final result, hair can be grafted or carried into the scar area. Scar revisions and other options will depend on the unattractiveness of the area. ​ Have him / her request “out-of-office-hours” time with the surgeon to discuss how things are going and what to expect. You may also find chat rooms where other patients have had a similar experience and offer their own recommendations. ​ ​I hope this has been helpful. I wish your relative the best!
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