What actually CAUSES incision breakdown and necrosis?

It is probably a combination of all the above.  All are causes of wound dehisence.  In post-bariatric patient, however, the nutritional deficiency is the most likely culprit.  This is because most patient will have deficiency of protein, amino acids, vitamin A, C, B1, B6, B12, folate, iron, zinc, selenium and a few other vitamins athta are not so important.  I reviewed this topic in a recent publication for Plastic Surgery Journal titled: Nutritional Deficiencies of Post-bariatric Body Contouring Patients: what every plastic Surgeon must know.  You can read the abstract on my site: http://www.plasticsurgerybodycontouring.com/index.php/learning-center/articles-booklets/

All the mentioned vitamins are important in boosting your immue response and for optimal healing.  See: http://www.plasticsurgerybodycontouring.com/index.php/plastic-surgery/post-bariatric-body-contouring/consultation/

This is the subject of my follow up publication in Plastic Surgery Journal that came out in December.  The reality is that the doses needed for optimal healing are much higher than a standard multi-vitamin.  The doses needed can be up to 10 X higher.  In my pratice, I have been able to reduce my patinet's complication rate by 1/2, using ProCare nutritional supplement.  This product is specifically formulated for the post-bariatric body contouring patient.  See http://www.plasticsurgerybodycontouring.com/index.php/learning-center/enhanced-recovery-after-surgery/

It is not too late to take the supplement.  It will enhance your recovery and healing. 

Best wishes,


www.plasticsurgerybodycontouring.com

Dr. Agha,

Where can I purchase the supplements? Can i buy them online?

Hi Jamie,

I am one of Dr. Agha's patients.  I took the pro-care and believe it really worked. Here is the website to purchase online.  Not sure of the cost (Agha includes the product in his fees).

http://www.nutressential.com/products.htm

Also there was another post a few days ago discussing pro-care.  Here is that post if you all want more info on it.

http://www.obesityhelp.com/forums/plasticsurgery/3893548/Que stion-about-Procare-for-Recovery/

I am no doc but I agree totally w/ the doc above...MUST HAVE SUPPLEMENTS!!!  Extra protein and vitamins are great but the minerals are just as if not more important to your skin.  It is not too late!!  With my WLS I had two hole in the wound that had to be packed for 4 months and it SUCKS!!!   But I also learned that my supplements are my friend and the doc is right this little RDA is bogus you must have more!!!  Most vitamins are water soluble so you are good but the minerals are not...do your research while you are taking it easy and take more then RDA on everything and you will be good...ok, not a doc but do some reading and remember, before this crazy influx of presciption drugs this is how sick people were treated...with extra vitamins/minerals/enzymes/herbs/etc...the natrual stuff.  Ask yourself what you would do if you couldnt get a man-made product to treat yourself...technology and invention are great if they can be used moderately....unfortunately, that went out the window a long time ago. 

We WLS'ers can not afford to know nothing about nutrition and how our bodies work, we have forever altered how they work and need to understand how every nutrient affects our bodies...inside and out...  I can attest to good tests but I know mine have improved drastically when i took good supplements and paid attention to what my body needs. 

Take a deep breathe and smile, this is only temporary and it too will pass...it will get better...;)

www.nutressentail.com

Most patient will need 2 bottles- about 110 dollars I believe.  Ask for the bariatric Formula.  It tastes much better.  The trick is that it needs to be made into a smoothy with ice.  I like to add canned pine apple to it personally.

Good luck and let me know of your progress.

Agha
[email protected]

I can't stand stuff that you have to drink.  Yuck!  If I can't take a supplement in a pill, I won't do it.   

It is usually as simple as poor blood flow to the area.
A surgeon can tell if you have issues before surgery, because almost ALL morbidly obese people have thin skin and less blood flow in the area after weight loss.  But nobody can tell if you will have skin necrosis.
I had an area of skin die after a TT. It eventually healed by being cut away as it died, and the living skin being re-sewn.  One of my problems was an old scar from having my gall bladder removed years ago. Previous surgeries can compromise blood flow when the skin is cut, and pulled tight during a TT.  Another problem was my protein was low during healing, but this isn't usually a real problem unless one has WLS and doesn't address extra protein needs after PS.
Skin and tissue necrosis is  a risk mentioned by every surgeon who does PS.