Knee Infection* Failed TKR revision - fusion/amputation advice

[bockoman]

Fusion and AK amputation are not good options. Get a second opinion from a top plastics person and maybe they can transfer some of his gatroc muscle to cover most of it as my wife had done. She had the skin graft and a large constrained joint put in that got reinfected a year later. She was given the choice of amputation or living with the draining infection. Since she can still walk it was far better for her state of mind to live with the necessity of daily dressing changes. Fusion was never considered because her legs are quite long and it would make wheelchair life that much more difficult. If they have a way of closing it that may be better since amputation can always be done. The majority of skin grafts do not fail

This is really interesting @bockoman thank you. It's really interesting to hear from someone who chose to opt for living with wound and having bandage changes. That is currently what my Dad is doing, with a negative pressure machine to drain the wound which means he can go longer without having a dressing change. Please could I ask how long your wife has been living with the wound and daily dressings? Did her skin graft not work or only partially work? Thank you

The skin graft worked fine. The drainage is from the subsequent staph infection a year later. She has 3 sinus tracts around her knee and one to two drain at the same time. Been doing this for about three years at this point. She's on Bactrim DS and Cefadroxil and is folled by an ID doc with quarterly blood tests.

 

[bockoman]

@bockoman also, what type of dressings does your wife have? Is there something in particular that assists in preventing infection? Thanks again, really appreciated

I've been managing the dressings myself (retired Podiatrist). Because of the volume of fluid released I've been using superabsorbants (Zetuvit+ or Vliwasorb) or a calcium alginate covered with gauze. Use Medihoney on the surface lesions (no reported resistance) when they occur and Cavilon if she gets an adhesive reaction. As far as dressing retention either Tegaderm or Hypafix. Hope this helps.