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Anyone else having trouble with the "glue"

Discussion in 'Knee Replacement Recovery Area' started by Boston mom, Aug 3, 2012.

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  1. Boston mom

    Boston mom New Member

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    I am so glad to have found this site. My husband had TKR surgery on May 23 at Baylor Hospital in downtown Dallas. Boy were there a ton of things no one told us about what to expect. He has had all the issues that people have referred to on this site and is gradually getting that part better. However, his incision was "glued" and his incision is still not well after almost 10 weeks. The surgeon said that for some reason some of the skin died at the incision site and so for many weeks we have had to drive 8 hours 400 miles for the surgeon or his PA to take 2 minutes to look at it and tell how dangerous it would be if it got infected. There is still red raw looking around the incision itself and still bleeds and runs and we are still having to put iodine on it daily and keep it covered with bandages. Now this is going on forever and we are wondering if it would have been better if the surgeon had put staples instead of the glue? Not sure what is going on or when he will ever get this well. Something has to give. He had the problem with pain an the hydrocodone really messed up his diviticulitis and his colon. We finally got past that but are still fighting the incision getting well. Anyone out there have issues with their incision or having it glued and are there any suggestions as to how to get this thing well? We are at our wits end here......:sorry:
     
  2. Pumpkln

    Pumpkln Forum Advisor

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    Welcome to Bonesmart sorry to hear about all the problems. From what you have described. You might want to seek a second opinion about the delayed incision healing. You are close to Dr. G. Maale in Dallas Fort Worth, he specializes in complex TKR knee infection and is well regarded among his peers. I wll tag some of the moderators, they may have more information for you. Jamie; Orthodoc;
     
  3. Jamie

    Jamie Administrator

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    Hi, Boston mom....welcome to BoneSmart. I'm going to tag our forum nurse, Josephine, so that she can comment on your concerns. Josephine

    You say the incision "bleeds," what does that mean exactly? How much blood? Is it daily? Just generally or when bending? A little blood at a couple of months might not be a problem, but if it's very significant, that should probably be checked out by the surgeon. Have you seen him??? If so, what were his comments?

    Dr. Maale focuses on difficult infection cases, so until you are sure this is the problem, I would try to see your own surgeon. If you don't get anywhere with him and you're still concerned, seek a second opinion.
     
  4. ChrisO

    ChrisO Member

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    I would also recommend a second MD someone who is a wound specialist, and someone closer to home. (You are exhausting yourselves with these trips.) They might want to try appling a gentle wound vac. If you can find a hospital with a hyperbaric oxygen chamber near you you should call them. Hyperbaric oxygen is very useful helping slow to heal wounds. ChrisO
     
  5. Dmgkag

    Dmgkag Member

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    Sorry you are having such a hard time with the incision. One of the problems is having to drive 8 hr.for each apt. Is it possible for the surgeon to recommend a doctor who is in your area to treat this and to make sure there is no infection? You definitely need more support with this than you are getting now. We have a nurse expert, Josephine who will be able to give you help. There is also Orthodoc who is one of our members. I am not sure how to tag them but someone will be along soon to do this. Stay in touch..you will be supported here.
     
  6. Janet2012

    Janet2012 Don

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    Gosh, that sounds horrible. I had glue and had no problem. I know someone who had some minor problems and it was suggested that she might have been allergic to the glue. I wonder if that could have been a problem for your husband. I would certainly try to get some cooperation in having someone local keep an eye on it and keep the surgeon informed. There are wound specialists which might actually know more about this than a surgeon.
     
  7. RestAssured

    RestAssured Forum Advisor

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    I am sorry to hear about the problems with the glue as well! As Jamie said Dr. Maale deals only with infections and tough cases, I am one of them. If you could find an OS that is close by to look at the incision that would be helpful! 8 hours is a long way to travel! I have a 6 1/2 hour trip every time I go to Dallas but I usually fly Southwest.
     
  8. KayeKaye

    KayeKaye Senior

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    I had foot surgery in 2005 and the wound didn't close or heal for over a year. I was sent to several wound experts and they tried all sorts of things and medicines and nothing helped. One doctor sent me to a cosmetic surgeon who wanted to do a skin graft. But I didn't feel like that would heal any better plus end up with the donating graft area that might not heal. Didn't hear about the "wound vac" back then, it sounds like that might be a good try. One thing that my PT mentioned was to stop using Ibuprofen because it retards wound healing so I stopped and it did start to heal. I was taking 4 200mg tablets 4 times a day so that was lot.

    One thing my original foot surgeon said about the wound was:
    If it's wet keep it dry,
    If it's dry keep it wet.
    don't really know if that is sound advice or not...

    Even going to your general practitioner would be better than traveling 8 hours. I am planning on going to Mayo Clinic and using my GP here afterwards for most things. They said I would only need to come back once and then it's fine to use your own doctor.

    For sure when the other knee is done do not use the glue if he had this reaction.
     
  9. Orthodoc

    Orthodoc Forum Advisor

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    I am sorry your husband is having such difficulty. Here are a couple of thoughts.

    I wouldn't concentrate to much on the technique of the closure. Some OS's use sutures with staples, some use sutures alone and others use a combination of sutures and "glue." His surgeon would have used a technique that he felt comfortable with and has had good results.

    The problem here ultimately is that the wound has not healed appropriately. There are a couple of reasons for this such as underlying infection, poor blood supply, poor quality tissue for closure, significant pressure from swelling, etc...

    The size of the skin necrosis is important to take into consideration when considering the treatment. I personally feel that any complication of wound closure over a knee replacement should be treated aggressively. It's important first to confirm there is no infection. Second is to get the wound closed quickly. The longer the wound remains "open" the more likely that a deep infection can occur. Yes, there are several techniques to allow for delayed closure (such as wet to dry's or the use of a wound VAC). However, it is not unreasonable to consider surgery for revision of the wound. It's possible that a plastic surgeon could also need to get involved (for a flap) if necessary. That would only be necessary if the skin necrosis was significant.

    I do not mean to alarm you with any of these recommendations. Your husbands surgeon knows the clinical situation much better than I do. I just wan't to give you some more information to consider. Good luck!

    Orthodoc
     
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  10. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    How about posting a photo of the wound?
     
  11. tashia

    tashia Sr Bonesmartie

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    I had my last knee using the glue. What has happened to me is a rash on one side and it has gotten smaller but still there. I used some cream for a while then stopped because it didn't seem to help. The skin is still more than tender. I have made a appointment for my doctor to have him look at it. By next week I hope its better than it is better than now. I hope by now you are well healed or very close to it. Do take care. :puppysmooze: Tashia :bicycle1:
     
  12. PooShay

    PooShay Sr Bonesmartie

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    I had a bilateral TKR at Baylor and my surgeon used the glue. I've had no problems. I'm sorry your husband is.

    Post a pic as Josephine asked. Hopefully, things are going better and your husband is seeing a doc much closer to you.
     
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