Scab/Crust Removal

[GEO147]

Hi all,

I had 3400 grafts done in Dr Cinik Clinic on 8th December. Everything seems to have gone well, however I am still entirely numb in the recipient area and partially in donor. I also had excruciating pain in donor for a few days but seems to be subsiding slowly. 

 

My main concern is that I still have some scabbing in recipient area after 2 sessions of massage and attempted removal. I am worried that by going too hard I have created scabbing or by going to light I am not getting it off. I don't know which as I am 100 numb there still. 

If anyone has any advice I would be very grateful. 

I received a WhatsApp from the clinic saying they were there to support me but when I responded for guidance I hot no reply. That was 5 hours ago. 

Edited December 18, 2021 by GEO147
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[Melvin- Admin]

 

[GEO147]

Thanks. I have watched this video before and I have done all that. My issue is the remaining scabbed area after 10 days and it's stubbornness. 

I'm afraid to push too hard in case I causeote damage than good. The rest 9f the area in recipient was much easier to clear. 

Any other advice welcome also. 

[Melvin- Admin]

14 minutes ago, GEO147 said:

Thanks. I have watched this video before and I have done all that. My issue is the remaining scabbed area after 10 days and it's stubbornness. 

I'm afraid to push too hard in case I causeote damage than good. The rest 9f the area in recipient was much easier to clear. 

Any other advice welcome also. 

Let me tag @DrTBarghouthi

[AlexMeister21]

How are you attempting to remove the scabs? My clinics instructions were to get a sponge, soak it in lukewarm water, and squeeze the water over the recipient area for 30 minutes. Then after the scabs/crusts are softened by water, use a finger and gently rub the crusts in a circular motion until they come off. You can also try putting Johnson & Johnson baby shampoo on the area and then rinsing off after a couple minutes.

[FUT4000]

19 minutes ago, AlexMeister21 said:

How are you attempting to remove the scabs? My clinics instructions were to get a sponge, soak it in lukewarm water, and squeeze the water over the recipient area for 30 minutes. Then after the scabs/crusts are softened by water, use a finger and gently rub the crusts in a circular motion until they come off. You can also try putting Johnson & Johnson baby shampoo on the area and then rinsing off after a couple minutes.

I tried all of that as well plus Melvin’s conditioner technique and it’s day 9 for me with the same problem as OP. Post op instructions said it might take a few tries and not to force it. 

[blackislback]

If you had HT on 8th dec, your 1st washing should be on 11th dec, 3rd day after surgery, as 72h is usual time necessary grafts "apply" to transplanted area, so you still have 2 more washing head, and some doctors suggest continue 3-5 days more, if not all scabs removed at first 10 washing head.

Don't press it hard, don't use nails, but easy massage, apply that lotion you get, wait 30-60m, then 2x times wash by shampoo you get by clinic, and water not too hot, not too cold, some middle, warm water, easy massage and they will remove easy.

You had probably more bleeding at that area where bigger scabs, and they need time to go off, practice little bit longer than 1-2 minutes hold water over your head, to be more wet, like 3-4 minutes and maybe 2-3 minutes massage by shampoo, and then wash it 3-4m by water, should go off those scabs.

[GEO147]

Thanks for all the responses so far guys. Good to know this isn't abnormal. 

[AlexMeister21]

58 minutes ago, rambunctious said:

I tried all of that as well plus Melvin’s conditioner technique and it’s day 9 for me with the same problem as OP. Post op instructions said it might take a few tries and not to force it. 

Yeah I forgot to mention not to force removing the scabs/crusts. It took me a little more than a week to get rid of all of mine, trying to remove them carefully each day.

[DrTBarghouthi]

Thanks @Melvin- Moderator

Did you by any chance hit bang your head against anything? (Car door, oven hub etc )as with reduced sensation it can easily happen. I think there was more bleeding there. It doesn’t look like necrotic tissue to me. I tend to use olive oil at day 8 and let it soak overnight for 2 days and then do the 10 day wash. Try applying olive oil on it for a day or two or anything that will soften it. Eventually that scan will fall when skin underneath is healed better. 

[GEO147]

3 hours ago, DrTBarghouthi said:

Thanks @Melvin- Moderator

Did you by any chance hit bang your head against anything? (Car door, oven hub etc )as with reduced sensation it can easily happen. I think there was more bleeding there. It doesn’t look like necrotic tissue to me. I tend to use olive oil at day 8 and let it soak overnight for 2 days and then do the 10 day wash. Try applying olive oil on it for a day or two or anything that will soften it. Eventually that scan will fall when skin underneath is healed better. 

I don't think I hit my head. I'll do the olive oil tonight. Should I skip the wash tomorrow and do olive oil again and wash on Monday?

 

Thank you for your advice. 

Edited December 18, 2021 by GEO147

[DrTBarghouthi]

No do the olive oil and wash daily. Just leave some good gap between applying the oil and the wash. 

[GEO147]

9 minutes ago, DrTBarghouthi said:

No do the olive oil and wash daily. Just leave some good gap between applying the oil and the wash. 

Thank you so much for your advice DrT 

[FUT4000]

1 hour ago, DrTBarghouthi said:

No do the olive oil and wash daily. Just leave some good gap between applying the oil and the wash. 

I'm curious if there is a downside to the scabs slowly coming off? 

[GEO147]

6 minutes ago, rambunctious said:

I'm curious if there is a downside to the scabs slowly coming off? 

I'd like to know that too. But I have just applied olive oil before getting into bed. Would be interesting to see a pic of your issue too Rambunctious just to see if we are dealing with same issue. 

This forum is great. Has given me some reassurance. Fingers crossed this isn't a significant issue.  I will update. 

[GEO147]

Another wash done. We have managed to remove a fair bit more but still some persistent scabs. 

 

Should I use the oil again later when it dries before bed or use saline spray during the day or what?

 

Thanks guys. 

[DrTBarghouthi]

I would stick to the oil for now. The saline might make things more itchy at this stage. It does look much better. Well done. 

[GEO147]

Thanks so much you are a gentleman.  Should I put oil on now or wait till bed time? 

Its 2.30pm here

[DrTBarghouthi]

I think now and before going to bed is better. 

[GEO147]

18 minutes ago, DrTBarghouthi said:

I think now and before going to bed is better. 

Again thank you so much. 👍

[ciaus]

15 hours ago, rambunctious said:

I'm curious if there is a downside to the scabs slowly coming off? 

The problem with the scabs is that if they get bumped, swiped, or catch on clothing, a tight hat, etc, and come off, they can potentially pull out the associated graft under the skin too -if the graft hasn't finished anchoring to its new blood supply. And the grafts should be fully anchored within 10 days.

Other than that, the downside for having the scabs around for longer is basically cosmetic, doesn't look as nice. But there are important hygiene and healing aspects to ultimately removing the scabs, so be sure to continue gentle soaking and washing each day. Dead scab material and shedding skin sitting on the surface for weeks increases the likelihood of pores getting clogged, leading to pimple-like infections under the skin. And that's not something you want your grafts to be contending with as they start out in their new home.

[GEO147]

As of yesterday this is how it looks. It has taken a long time to get here. Just wondering why this happened and if there will be any long term issues where skin is red/damaged. 

Have tried asking clinic but that's a complete waste of time. Aftercare is non existent. 

[gillenator]

Without question there’s an improvement!

[Forty Six & 2]

My surgeon told me to apply panthenol foam (alcohol free) and wear a shower cap for 30 minutes. This softens the scabs a lot and you can gently rub from the back to the front. Never force it.

[gillenator]

On all of my procedures I simply allowed warm water from the shower to run over the grafted area for about 5-7 minutes, then I applied shampoo over the area and set for approximately 10 minutes and the crusts rubbed right off.