Necrosis after Sub-Coronal Incision & Auxetic Cuts - Journal

[newhope]

my gosh... another reasons to avoid subcoronal approach...

[splitpeach]

To me it looked like the tape was too tight around the incision and it stayed on for too long in the background of edema and swelling. Now im no urologist hahaha. So dont take my word for it. But i hope you dont get an infection. I think overall you should be safe as the implant is in a deeper space, within the corporal bodies, and the corporotomies are done further down. I think once all that necrosis is confirmed and finalized, your surgeon may suggest a circumcision to remove the skin and give you a cleaner cosmetic look. That may look better than healing with scarring. But i guess to someone uncut your whole life. May also be daunting.

I too think the tape was too tight. But also the edema was present almost right away and I think should have been considered when I was still in hospital. I think it should have at the very least been addressed during my follow up on Day 4 - Tuesday and the tape removed to view the incision line. If that would have happened perhaps we could have saved more skin.

I don't know for sure though obviously.

I'm not very keen to be circumcised. I've never wanted it. I've also lost sensation from my first surgery and I understand that circumcision further reduces sensation.

Again, bright side, the cylinders seem fine, no sign of infection, glans is fine, deeper tissue is fine. Just the appearance seems to be affected.

That's bad enough for me but it's not yet quite time to jump off the building.

[splitpeach]

So the necrosis should be self resolving? Did hakky agreed on this view?
And yeah, i would also be concerned with developing an infection on top of it. I hope you a are taking a good amount of antibiotics.
Keep us posted bro

IV Antibiotics 3 x per day. The necrosis MAY be able to be filled in with skin from the border, but may require a flap / graft.

Infection now is my biggest priority to resist.

[splitpeach]

my gosh... another reasons to avoid subcoronal approach...

I've heard different opinions from everyone I've spoken to. Some say that Sub Coronal approach is well known for being high risk for necrosis. One fellow said it's ABC foundations of andrology.

Others have said its because of the edema pressing on the incision line constricting blood flow. Other comments were the tape, others were that the blood flow for the skin was compromised from the degloving and / or auxetic cuts.

Some say it's a combination of all of the above.

But yes, I think SCA needs to be demoted as a surgical option

[1984ptc]

I think its all a guess at this point. Degloving and associated edema. Having more edema especially past the incision line probably because you were uncircumcised with resultant paraphimosis. Your last pics looks better though.. those areas will scar though. You may need a skin graft or hopefully once all the edema dies down, you have enough loose skin to just get a circumcision. Interesting how big your dick got post auxetic that the foreskin essentially just stayed retracted? Are you still inflated?

[duke_cicero]

I do wonder if the auxetic cuts had anything to do with this. I'm not a doctor by any stretch of the imagination. I'm so sorry that you're going through this, man.

[dan_bionic]

Hey splitpeach, sorry you go through all these, however, this just seem to resolve but it'll take some time. The superficial skin will be replaced by a new skin layer and the deeper layers are not involved, so there is no danger for your implant. If you are in a medical facility, they know what to do, just wait, be patient, take care of the wound, changing the dressing by a fresh sterile gauze, take antibiotics and relax, it'll take some time, but it'll be resolved with no further surgery.
Take care and relax, bright days are coming and you'll enjoy your bionic dick, with some more waiting and recovery time.

[splitpeach]

I think its all a guess at this point. Degloving and associated edema. Having more edema especially past the incision line probably because you were uncircumcised with resultant paraphimosis. Your last pics looks better though.. those areas will scar though. You may need a skin graft or hopefully once all the edema dies down, you have enough loose skin to just get a circumcision. Interesting how big your dick got post auxetic that the foreskin essentially just stayed retracted? Are you still inflated?

It's a bit of a mystery where my foreskin is. My dick is very swollen though atm. Perhaps additional swelling from auxetic cuts and tight suture line contributed.

I'm encouraged by the bleeding in some of the lower scabbed areas. I hope that'll grow back. I do realise I'll have scarring though. Just hopefully try to minimize it.

I don't know exactly how inflated I am. I took morphine to try and fully deflate, so I might just be very swollen. I think you have to understand that most of the size increase you're seeing is swelling and not from the auxetic cuts as I'm not fully inflated.

[splitpeach]

Hey splitpeach, sorry you go through all these, however, this just seem to resolve but it'll take some time. The superficial skin will be replaced by a new skin layer and the deeper layers are not involved, so there is no danger for your implant. If you are in a medical facility, they know what to do, just wait, be patient, take care of the wound, changing the dressing by a fresh sterile gauze, take antibiotics and relax, it'll take some time, but it'll be resolved with no further surgery.
Take care and relax, bright days are coming and you'll enjoy your bionic dick, with some more waiting and recovery time.

Yes, it seems like it will be ok. I just want to minimize the skin damage and try and get it close to normal as possible.

I'm meeting the consultant today finally so will see what the plan is. I'm also going to go to a wound clinic to ask their opinion.