Infection

[Brit-Knee]

I'm told that the infection on my knee scar is caused by a small piece of inner disolvable stitch working through.Did'nt know about this as I thought there were only staples.Taking one Flucloxacillin four times daily for one week then I'm away on holiday for ten days.I have to return to the hospital for a check up two days after returning home. There is now just a small scab with very small red area around it now,does this sound ok? Also I'm wondering if it's safe to shower or bathe I forgot to ask the nurse and no doubt she would have mentioned it if it's not a good idea but I thought I'd check to see if anyone else has had a similar problem. I've been reading through the back postings and it's just amazing how many of my questions have been answered without my even having to post them. There are a lot of kind caring people out there in 'Bonesland' Thanks again to you all Brit.

 

[Josephine]

Well, y'know, there's more to closing an incision than staples, Brit! Surgeons refer to this as 'closing in layers'.

Closed with a strong dissolvable suture such as Dexon or Vicryl;

• the joint capsule
• the deep layers of muscles
• the superficial muscle layers
• the tough covering of the muscles called the tensor fascia lata

Closed with a thin dissolvable suture:

• the fat
• the subcuticular layer just between the fat and the skin

Closed with staples or steristrips:

• the skin

Occasionally the subcuticular stitch does cause problems, especially if the ends aren't properly buried. They will then protrude through the skin and hold it open, much like the drains did. This is why there is a potential for infection but it is unlikely to penetrate more than a few mm into the wound, certainly not as deep as the joint. Sometimes, this suture material has to be removed in order to allow the wound to complete its healing.

 

[hess]

I'm told that the infection on my knee scar is caused by a small piece of inner disolvable stitch working through.Did'nt know about this as I thought there were only staples.Taking one Flucloxacillin four times daily for one week then I'm away on holiday for ten days.I have to return to the hospital for a check up two days after returning home. There is now just a small scab with very small red area around it now,does this sound ok? Also I'm wondering if it's safe to shower or bathe I forgot to ask the nurse and no doubt she would have mentioned it if it's not a good idea but I thought I'd check to see if anyone else has had a similar problem. I've been reading through the back postings and it's just amazing how many of my questions have been answered without my even having to post them. There are a lot of kind caring people out there in 'Bonesland' Thanks again to you all Brit.

Brit,

I too am trying to get over an infection in the incision. I was on antibiotics for 7 days, when the doc checked it, he said that it looked good, and the incision would heal up soon. So, I left for vacation, and am going home tomorrow after 7 days. It is still not healed up. I called yesterday, and they said that it could take 2-3 weeks for it to totally heal up????

I did feel better, though, when the doc said that the new knee is not infected. He said that the prosthesis is fine, this is just a superficial infection. They said that I can shower, but it probably would not be a good idea to bathe as you are sitting in the water.

Hope this helps, and good luck with the infection,
Hess

 

[Brit-Knee]

Many thanks Josephine and Hess for speedy replies.Well Jo who would have thought there is so much going on in these knees,that was a really in depth answer and very interesting,you really do a good job here.Hess I do hope things are going well for you now let us know your progress thanks again and now for that shower.Great info from Jo was'nt it?.Cheers every one, have a good day, Brit.

 

[Josephine]

My pleasure!


Actually, I just like showing off!

 

[Dedicated_Dad]

I personally wouldn't take a bath (or pool, hot-tub, etc) until all scabs are gone. Bacteria are very dangerous...

Funny... I had a little thing under my skin. I was worried about it -- thought it was a bone sliver since I could move it around -- but Doc said it was a suture and not to worry about it. Not sure where it went, it was loose and I lost it under there...

OTOH, my incision was nasty, crooked... I had a little "nipple" at the bottom where it was stitched up crooked... It's since disappeared, but it was excruciatingly sensitive for a while...

Sorry to hear you're having trouble, but hang in there!!

DD

 

[Josephine]

Would have been an absorbable suture, Dad. And they do go all hard just before they dissolve.

The 'dog ear' of which you speak is sometimes due to one side of the incision being stretched during the op more than the other so there's some slack to be taken up. They're not at all uncommon but do flatten out and disappear in time, usually a few months.

 

[Dedicated_Dad]

I was surprised not to see the cross-marks usually made before cutting to align incision when closing...

When I first saw my incision I commented to the nurses "what -- was it kindergarten day and he let one of the kids staple me up?"

It was sloppy -- even the nurses agreed... Some of the staples were even not inserted right... I'd have pulled them out and redone them. I kept bleeding for several days - not excessive that I was worried about losing blood, but enough to soak through many layers of gauze. They wouldn't put me on CPM until it quit bleeding, but it never did quit so I never got the CPM. I was in Rehab for a couple of days before the bleeding finally quit - ~5 days after surgery.

He cut straight down the old scar - which was string-straight before - but now weaves back and forth a bit.

I know I've been complimentary to him -- perhaps too much so -- but in this case I just can't. The closing was sloppy work...

DD

 

[Josephine]

Haven't seen anyone do the cross hatching thing for years, Dad. As I said, sometimes one side of the wound gets stretched with the retractors and that can complicate the closure. Don't think even the chest surgeons use cross hatching anymore.

 

[Dedicated_Dad]

Huh. In my previous open reduction (2002) they did it -- drew incision line with a marker, with perpendicular lines every inch or so to line it up -- on my anterior incision. This cut was <1 inch shorter, down the center of the old scar...

They also did that on the "fasciotomy" incisions done in '02 as well... I just assumed it was common practice.

Learn something new every day! Thanks for adding to my ejumucay-shun!!

DD

 

[1jt@atime]

My surgeon draws pictures on the surgery leg in pre-op. Last summer, (Scope) I got a beach scene, then in the fall I had pumpkins and a scare crow and on June 9th he drew a picture of ships returning from D-Day (June 6th). Okay, that last one was kind of lame but maybe he was running out of new ideas for me. I wonder what he'll draw on my a** when he does my hip?
Karen

 

[Josephine]

Huh. In my previous open reduction (2002) they did it -- drew incision line with a marker, with perpendicular lines every inch or so to line it up -- on my anterior incision. This cut was <1 inch shorter, down the center of the old scar...

They also did that on the "fasciotomy" incisions done in '02 as well... I just assumed it was common practice.

Learn something new every day! Thanks for adding to my ejumucay-shun!!

DD

oops! I was thinking about when they used to scratch with the (blunt) back side of the scalpel blade! My age is showing!

Truth to tell, very few surgeons would do that with a marker as it can get embedded in the cut edge of the skin and end up a permanent mark like a tattoo! Patients have been known to take exception to that!