I'd sure like to talk with others who have experience with a free flap. My husband's first one was from the iliac crest - to form a jawbone-and the 10 inch scar was minimal.

This second one is from the forearm and very different. I wonder if I should be doing something to minimize scarring. There is a piece in the wrist that is approximately 2"X4" and looks like mince meat, and then there is a 12" laceration that is raised with a hard crust. The doctor said we didn't need to do anything to it - but then, that is from the surgeon's viewpoint. He is wonderful, but not concerned with looks.

If anyone else has experience, I'd appreciate your sharing.

I'm going to let others who have had tissue flaps and grafts respond to you here, but I would like to make one clarification. What was taken from the iliac crest of the hip bone ( a common bone donor site) is a bone graft and not a free flap. These are two different animals.

My husband has had two skin grafts taken from his upper right leg for two reconstructions, the first one took forever to heal, ended up just leaving gauze on and cutting the edges as they came loose, for a while we did wet to dry dressings 4 times a day, but that was really painful..........anyhow, that was in November, and I am amazed at how much the scarring has faded from the first one....the second was in March and is doing well............docs do like to let them heal on their own, unless they get infected.

Betty.......I get all confused with the terminology regarding free flaps....but if you're talking about taking a huge chunk of flesh from the forearm, along with a vein to rebuild the tongue and floor of the mouth then I can help you.

When I first saw my forearm after surgery I nearly fainted; I had no idea they would need that MUCH skin from my forearm---I actually had a hole in my arm. They did take a graft from my leg (OUCH!) to cover the hole in my arm but still, the hole was deep. In terms of healing, I had no problem although today I do have a nasty scar and a small indentation of skin but nothing like the hole that once was there. After my arm began healing I was referred to an Occupational Therapist who had me wear this rubbery/plastic band (I don't know what it was called) and as she explained it to me, the band would help the skin raise up and become more even so that I wouldn't have a big gaping hole in my arm in the future. I was to wear this band 24/7 for at least a year, which I did. And I have to say it seemed to help. Like I said, I still have a scar but not nearly as bad as when I first saw what they had done to my poor arm. As for the graft on my leg---well, that took FOREVER to heal like Dharmacat said, and that thing hurt like the dickens too. There was nothing we could do with that graft except at first keep the gauze moist to lessen the pain. We would cut around the gauze as it graft began to heal. Today I have a square white box on my right leg which used to be a graft. It is albino white and never darkens even in the sun, but at least it is flat with the rest of my skin and it isn't a hole.

I hope this is what you are asking/talking about and I was of some help. But like I said, I get all confused when someone mentions a free flap. There are just so many different donor sites and different termology for each one too, or so it seems that way anyway. Hope your husband continues to do well. Sincerely, Donna

Thanks, everyone, for your time and sharing.
I get confused on these definitions, as well, but I thought definition of free flap was when they take tissue, including veins, and separate it completely from the original site. A 'flap' is when it is still connected.
A skin graft is different-he has had many. We had enormous trouble with the first one - the site was so big and draining so much blood that they had covered it with a clear bandage that was not to come off until the blood dried. There was so much blood that it did come off, and that started a very painful treatment plan of wet-to-dry saline dressings. Everytime the dressing would dry, we'd pull off the new skin with the dressing. It kept getting worse until we went to a wound care center - the nurse did the opposite of the doctor's wet-to-dry saline method, and it became pain-free and healed quickly. The wound care nurse said that doctors are still being taught to do wet-to-dry, but that it is obsolete technique when you want new skin to grow. He has had no pain with the last 3 skin grafts-each time, a net dressing was put on immediately, and as the skin healed from the inside, the net dried and became loose and he just cut those edges off - no pain, no problems.
Donna, your information was very helpful. It sounds similiar. I will ask the dr. about this 'band' and also about therapy. He does not have any feeling in his thumb and no strength in the arm. Thanks!

Just a quick note about wet to dry dressings......they are done to debride the wound........in other words to keep it clean and keep it from becoming infected. So, it does serve a purpose.It pulls necrotic tissue with it...So, as a nurse, myself, I do feel it has it has a purpose, however painful......but a point does come when other measures can be taken.........wet to dry hurts, but still serves it`s purpose!

AAhhhh! I'm SO glad to know there's a point to that torture! Thanks for setting me straight.

You are right about wet to dry being torture, at one point I was doing it from ear to ear on my husband, basically, since last Oct, until a couple weeks ago........that was all the nursing care we needed with the reconstructive surgery............believe it or not, with the first skin graft that took forever to heal, we ended up with some little known hemorroidal ointment, that the pharmacist kept behind the counter........but it really helped and we used on the second graft too.........so whatever works!!!!!!!