Thanks so much for your question. I have to say having had this procedure myself, it can be unnerving to have complications. I see some really healthy granulation tissue, and for tough fibrinous slough, Santyl plus an occlusive dressing may be a great addition to add moisture to debride the last bit of non viable tissue over the granulation. Silvadene can actually cause the slough to be dryer and tougher to debride in some cases, and I would not recommend that. Also, I understand plastic surgeons would tend toward treating for potential skin infections with prophylactic antibiotics, but would say those are not indicated without clinical signs of infection. The edges do look rolled so that may be an issue when the wound bed is healthy enough for skin to cover the area, this may be treated with debridement or silver nitrate.

I think that would be a good dressing regimen to add some moisture to the wound, yes--just ensure when the santyl is added to use plain petroleum gauze over the top as the xeroform can inactivate the santyl.

You can actually use santyl to complete healing if desired. Antibiotic ointment isn't recommended as it can stall healing and be allergenic.