Possible graft failure after 1 week?

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Posted on 10.17.2019 03:26 PM By Vikaskumar Patel In Soft Tissue Enhancement

Hi Everyone. I wanted to share case I did one week before and just saw post op for 1 week today . This just my 2nd case I did after the course and wanted to get your opinion.
Patient had recession on right upper 1st and 2nd PM area.

I have used Biohorrizon Alloderm . And Nylon monofilament sutures . Everything went well on appointment day but when I saw patient one week post op I saw large granulation white area . Wanted to know is it normal or its getting rejected. If thats the case what can I do to improve ?

Thanks

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2 Comments

Maurice Salama says on 10.17.2019 04:39 PM

Dr. Patel; Yes, the graft has sloughed. Not sure from images but could be pressure from flap or wicking from the alloderm that allowed bacteria to enter. I no longer utilize Alloderm for that very reason....very slimy and if exposed does not do well. Always try to get COMPLETE 100% coverage of the ACDM with the outer flap. good luck and thanks for sharing. Dr. Salama

Vikaskumar Patel says on 10.18.2019 10:23 AM

Thank you Dr Salama for the response I tried to cover completely but looks like I might have missed something . How do I manage this ?Should I just go ahead and remove and clean the area ? or should I wait some more time and see ? Also if not Alloderm , which one you recommend moving forward? Thanks for the suggestions Vikas