You would be surprised he will heal quickly barring any complications from his previous rads. I had 30-40 percent of my tongue removed and was sitting on a beach in Mexico literally 17 days later. And enjoying the buffet. - I had 40 nodes removed from my neck as well. Muscles cut etc... Soooo I've been there. If he keeps up with his oral hygiene and starts therapy for his shoulder and neck and does his tongue exercises, you will be surprised how well he will do. Tell him to stick to soft but controllable foods - scrambled eggs, omelets, pancakes etc... For a while put the food in on his good side, in small amounts then swallow with water.

So quick update...my dad is still in the hospital. He was doing great...was ready to move out of ICU in less than 24 hours, but they kept him for 2 days due to his fear of the trach. It's been 15 days since the surgery, but 3 weeks since he was admitted (due to an infection and barely eating due to uncontrolled pain.) He was scheduled to have the trach removed last week as he capped it right away and he did awesome, but he developed a new infection. They kept it in as a precaution and he still has it. He doesn't actually use it but they want it in in case he infection progresses. In addition to the infection, there is one area of the flap that isn't healing well. It's small but it is right in the front. They referred to this as wound breakdown and could be the result of an infection. Originally we we're told they would do some bedside debridement to clean up the area and remove some infected tissue to promote faster healing, but now they are talking about another surgery to remove the poorly healing tissue and pulling the flap forward and cleaning up the infected tissue area. Clearly he is devastated and in shock. We thought he would be home by now and testing swallowing. They won't let him eat a thing until he tests swallowing. Only good news is that they are going to go through the mouth rather than the neck and should only be about 2 hours in the OR.

Has anyone ever had debridement surgery? From what I've read, flap failure doesn't occur this late post surgery so hoping it is small enough and his flap remains healthy and viable. The surgeon wants to wait and see how things go as he may not need surgery. We are hoping he doesn't.... But if it will improve his speech and swallowing then we don't oppose it. According to another dr that stopped by, the area is stable and not spreading, which is great. my dad just wants the trach out and to be able to eat. Hoping someone can shed light on whether or not they've been through this... And hoping that this doesn't delay recovery tremendously.

Debridement surgery usually is not as involved as the original surgery. From what I understand its where the doctors go in and clean things up, making minor adjustments as they go. Its a common procedure with many who have had a free flap done will undergo this type of secondary minor surgery. Ive had this done also and it was no big deal. Mine was done as an outpatient procedure.

The biggest issue I can see is your father has had radiation. This makes healing much slower for OC patients. He could need stronger antibiotics such as IV antibiotics and it could even be used in combo with hyperbaric oxygen therapy (HBO). Ive done many HBO and it works great for helping me to heal when my wounds arent healing as they should.

Kris had to go back to the Operating theatre on Day 4 for debridement and re suturing. We were told it was due to his previously irradiated tissues breaking down. This was just a 2 hour surgery and didn't involve further incisions. He then went on to heal nicely. Our surgeons had warned us prior to the initial surgery that this was a high possibility due to his previous radiotherapy.
If tissues are breaking down then debridement is a must or you risk losing all the tissue.
Hope you Dad progress' s well from here. Remember it often is 2 steps forward and 1 step back.
Tammy

Thanks Christine and Tammy. Your responses alleviate some stress. We had a nurse tell us that she sees this all the time with patients that have been previously radiated. I am hoping we get some clarity as to what is going on soon. I am okay with the debridement surgery for repair if it's going to save the tissue. I just want him to be able to eat an speak soon. He's so anxious to get out of here, but who wouldn't after three weeks!

I wonder how much recovery is delayed by debridement.... Hopefully not much. I will ask about HBO but I believe it's done in individual pods here and he's claustrophobic which may pose a problem.

The debridement will actually help in the recover since it will get rid of the infection and clean up the area. The infection has halted things. Wish him luck tell him this is par for the course because of his previous rads. HUGS.