Asdf Bi Lateral Flap Diary

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Re: Asdf Bi Lateral Flap Diary

Postby asdf123456 » 05 Nov 2014, 15:49

It's all I can think about anyway. They do cover the fissure...If you imagine the fissure looks like a paper cut, long and thin...the surgeon first cuts all the necrotic/old tissue out of it and makes a nice new fresh wound that is ovular. The next question is how to fill it in...In the case of my first flap surgery, a y-v, the surgeon stretched in skin from just outside of my butt and sewed it in place to "fill" the defect. In OMB's surgery, the same thing happened essentially, but instead of skin, it was mucosa from further inside her body. In my last surgery, the surgeons pulled in a piece of skin from the outer left, and a piece of skin from the outer right. They both met in the middle, with which was the suture line right down the posterior midline. I hope that's easier to conceptualize.

If you mean to say that it sounds silly that they would create a suture line right in the the center of the wound, where the old fissure was originally, I totally agree. And I even said as much prior to the surgery. I literally told both the plastic surgeon and the CRS that I do not want a line of stitches right down the posterior midline, because it's a weak spot and I bet it will break. It turns out I was right, but the surgeons said they had to fill it that way, because it was a very broad wound and required half the skin to be pulled in from one side, and half from the other. It worked in Suzyjank's case, and for some reason didn't work in mine. I can't really figure out why though. The flaps healed in place and look good he said, so even if the whole center line of sutures ripped, the flaps should be close together and just fill out their center. I don't get it at all.
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Re: Asdf Bi Lateral Flap Diary

Postby Scientist2516 » 05 Nov 2014, 16:58

Thanks for the explanation. It's clearer now. I really wish it had worked. :cry:
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: Asdf Bi Lateral Flap Diary

Postby suzyljank » 05 Nov 2014, 19:40

Hi, when my flaps were done they removed lots of scar tissue and I believe the fissure and skin tags and I had lots. They did the two flaps and the donor sites were pretty big. My husband took care of me and he told me he was afraid to touch anything because it looked that bad. Sometime during the surgery they did dilation too. I remember when I started waking up they kept telling me I wasn't going home for a few days. I never looked at the surgical site. I saw pictures of it about a year after it was done and I'm glad I didn't look before. I continue to dilate to keep the skin stretchable. It was by no means a simple or quick recovery. It comes in stages. In april it will be 2 years and that's how long my CRS told me it would probably take. Since I had the surgery there are some foods I can't eat anymore because they cause diarrhea. Before the surgery everything was so closed off I needed the fiber and fruits to help me go. It's been a long road. If it wasn't for people sharing their experiences and support with me I don't know if I would have ever had the courage to go through the surgery. If you need to consult another CRS and get another opinion please do it. I feel awful for you but I do understand what you're going through because I've been there. Wishing you all the best. Suzy
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Re: Asdf Bi Lateral Flap Diary

Postby woundedspirit » 07 Nov 2014, 10:46

Hi asdf. Thank you for that explanation. It really helped me visual what the surgery is. And yes that would be my concern too about not putting sutures at posterior midline where the old fissure was but it sounds like there was no choice. Can I ask you and Suzy about how big are these flaps? Are we talking cm or inches? And having two fissures do you think I will have to have 4 flaps? I will have to have scar tissue removed too. How I wish I had never had the hemorrhoidectomies. I have an appointment soon to discuss details but this will help me with my list of questions. Thinking of you everyday. Praying it still may grow over and heal.
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Failed LIS
[size=85]EUA and Fissurectomy
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Re: Asdf Bi Lateral Flap Diary

Postby asdf123456 » 07 Nov 2014, 11:13

I saw a picture of my flap that the surgeon took in the OR. They look to be about half a stick of gum each. You would not likely have more than 2 flaps. Where are your fissures?
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Re: Asdf Bi Lateral Flap Diary

Postby suzyljank » 07 Nov 2014, 16:31

Hi, my donor sites were left open and they were each a little bigger than a silver dollar. I don't think they do four flaps. I've never heard of it. Are your fissures on the same side? Suzy
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Re: Asdf Bi Lateral Flap Diary

Postby woundedspirit » 07 Nov 2014, 23:00

Thanks guys, that gives me a good idea. They said I have one at the 6 o'clock position which would be midline but to tell you the truth I think it is just slightly left of that. And oddly enough no one ever told me the location of the other one only saying I have a second, but I am pretty sure it is around the 4 o'clock position. I will ask at my appointment. Did anyone ever tell either of you the length of your fissures?
Hemorrhoid Surgery
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2 Anal Fissures
Failure of All Topical Treatments
Failed LIS
[size=85]EUA and Fissurectomy
Hoping to avoid Flap Surgery
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Re: Asdf Bi Lateral Flap Diary

Postby asdf123456 » 07 Nov 2014, 23:11

Not precisely, no. If your CRS feels that your fissures are from excessive scarring, then they may not feel that covering both fissures with flap tissue is required to allow them to heal. If they remove the scarring and replace it with stretchy healthy tissue, then the fissures should heal on their own. That being said, my case may be evidence to the contrary, but I think I am just a freak of nature and was doomed from the start.
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Re: Asdf Bi Lateral Flap Diary

Postby woundedspirit » 13 Nov 2014, 00:32

Hi asdf. Thinking of you and hope you are doing better. Have you had any improvement?
Hemorrhoid Surgery
Scar Tissue
2 Anal Fissures
Failure of All Topical Treatments
Failed LIS
[size=85]EUA and Fissurectomy
Hoping to avoid Flap Surgery
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Re: Asdf Bi Lateral Flap Diary

Postby asdf123456 » 13 Nov 2014, 10:12

Nothing new from me. No notable improvements...The one positive thing I will say is that I have noticed that my poops are thicker now, which I guess is an indication that my stenosis has been addressed. Otherwise I am status quo really. My CRS said to return next week, but I am weighing just waiting longer to see him because no doctor is going to do anything on my 6 weeks after this big of a surgery...so I imagine he is just going to tell me to come back in 2 weeks again and again for a while, which I am not really interested in doing anymore.
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