TKR SusieB in recovery

[SusieB]

Hi
It will be two weeks tomorrow I got the TKR... I still feel good and glad I had it done!

I had my Staples out on Last Thursday and today noticed a Pin Hole leak in the Incision!

I went to my Internal Medicine Dr today and mentioned it to them!

I’m not worried about an infection inside but I am worried some bacteria could enter from the outside in!

Has anybody had a small pin hole opening on their incision?

They recommend triple ointment and a bandaid over the spot!

I was surprised they put gloves on and touched the spot .... I thought they would have at least touched it with a sterile gauze! Gloves are not sterile in my book!!!

I came home and dabbed the area with soap and water with a little of The Antibacterial Soap they gave as a Scrub before surgery! I then put some antibiotic ointment and a bandaid over it !!!

Let me know your thoughts???

SusieB

 

[sistersinhim]

I will tag @Josephine and ask her if you should use any ointment on it.

 

[SusieB]

Thanks... I too have questioned doing any exercises? I have sterile strips on the whole incision since Thursday. The pin hole is just above one of the strips! I know I thought the same thing about the ointment. Will stop it from scarring over? I sure don’t want any thing going in either!

 

[Diva68]

I had about four small places open along my incision/scar causing slight bleeding. My OS believed it was internal stitches that were not dissolving and working their way out. I wiped the area with alcohol wipes and used small bandaids. My doctor also ordered that I avoid PT and any exercise flexing the knee for about a week and a half. I was also prescribed cephalexin 500 mg as an antibiotic for 1 week. I have not had any bleeding for the past three weeks. I should also note that the antibiotic was just a precaution, my OS did not believe that I had an infection; I had no redness, pain or fever.

 

[SusieB]

I will be calling my Surgeon soon! Thanks for this info!
I agree it’s when I flex, sit with knee bent that I notice the little bubble and it’s little but it’s still an entryway for bacteria!
I’ve been doing so good I don’t want any complications!
Did stopping the pt make bending the knee harder after from not doing the pt???

Thanks Sue

 

[SusieShoes]

Is it a bubble, or a hole? Either way, calling your OS is a good idea. I called mine when a small pimple-looking thing appeared on one of my incisions. Turned out to be a stitch, but he told me how to take care of it until the stitch finished pushing out.

You've been doing great! These little scenic detours are part of the journey. Don't worry about your bend. Your OS already told you it's good and you don't need PT, which means you don't need PT to keep it that way. In fact, it will continue to get better all by itself. All you need to do now is go about your daily activities and move your knee like you normally do. If you want to go back to PT for other reasons, that's something you can do later.

 

[Diva68]

@SusieB, I was able to pick back up at PT after the week and a half with very little difficulty bending my knee. I also took a couple of days off work to give my knee some extra elevating time and TLC. I would definitely call your OS. Like you, I was most worried about infection which is probably the main reason he prescribed the antibiotic.

 

[sistersinhim]

Not doing PT will not slow your ROM down. Quite the contrary. No PT allows the knee's swelling to go down. That allows the ROM to get better.

 

[Josephine]

I had my Staples out on Last Thursday and today noticed a Pin Hole leak in the Incision! They recommend triple ointment and a bandaid over the spot!

Those holes are so tiny, it's not worth getting into a bate about them. They will heal up in time. And in the meantime, if they are wet and/or leak a bit, a Bandaid will do nicely.

I was surprised they put gloves on and touched the spot .... I thought they would have at least touched it with a sterile gauze! Gloves are not sterile in my book!!!

There are two sorts of 'cleanliness' in medicine.

1. sterile - no organisms of any kind
2. surgically clean - organisms that are not pyogenic, meaning they don't cause infection with pus
3. socially clean which is what your hands should be after you've washed them, leaving just ordinary commensals that are always on your skin and pose no danger whatsoever.​

The box of gloves the nurse use for general purposes are surgically clean so quite safe for changing dressings and such. It's only necessary to use surgeon's sterile packed gloves where there is a large open wound or when doing some surgery.

When one gets an open wound such as from a stitch or a staple, these are already contaminated so the surgically clean or even socially clean procedures are quite adequate. Generally, if these wounds - or as you described it, pin holes - are truly just pin holes then it's quite okay to leave them alone and let them dry out and heal on their own.

 

[SusieB]

Well called the Surgeons office and I am on Two Weeks of Antibiotics and have to have wound check on Monday the 19th! I’m just concerned... it is a pin hole in the incision maybe a little more as I can’t see under the steri strip below it!
Guess I gotta keep that Positive Attitude that all will be Well! It just feels like a dull ache in that area when I’m just sitting around .... maybe it’s just things knitting together?
Thanks for all the concern.... I sure do Appreciate All of your Support and Incite! Will keep you posted!

SusieB

 

[yesyvonne]

@SusieB, congrats on reaching two weeks out, and good luck with the antibiotics. Glad you'll have that wound check on the 19th. Yes, I think positive attitude will help you as well.

 

[Beckadeez]

I had a pinhole leak after my stitches came out, after my arthroscopy. It turned into cellulitis and I was given antibiotics that cleared it up. Better safe than sorry.

 

[SusieB]

Yup it’s really not PT its exercises the OS has/wants you to do 2-3 times a day! So you think I should lay off of those too??

 

[SusieB]

Well,
Here I am headed to Week 3 on Tuesday! I have to go in and have the incision checked on Monday, Due to the little leak last week!
I am still hanging in there... but the wind was taken from my sails 2 weeks ago when I learned of the Passing of my friends 19 year old grand daughter!
It was a horrific horrible murder....I’m sad and with not being able to sleep more than 2-3 hours at a crack at night it sure doesn’t help!
My knee is still tight and the heel slides on the bed seem to be going nowhere! In a chair I can get the 90 degrees and a little more but don’t want to push it!!
I’m just doing exercises at home so have no one to push me!! I know I don’t mean push but just encourage!!
I know I started off so good and now with the sadness I feel like I’m going backwards .... I went
Out side today and walked around on the sidewalk for a bit with my cane!! Somehow I gotta get that Positive Attitude Back Soon!!

SusieB

 

[Mutti3]

A good walk is always helpful to relieve tension, and clear the mind. This journey is full of up and downs.
Positivity is always waiting for you. Try to rest, it is one of the keys to recovery. Sorry about your friend’s loss.

 

[Celle]

I'm really sorry to hear about your friend's granddaughter. That's a terrible thing to happen.

You don't need to do a lot of exercises and there's no point in doing heel slides on the bed. You're doing them from a chair and you don't need to do them more than one way.

It's not exercising that gets you your ROM anyway - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

So, why not stop the exercise and, instead, take a little walk outside each day. With your other activities of daily living, that's all the exercise your knee needs.

 

[SusieB]

Well it’s 3 weeks today!
Went to the Dr yesterday for wound check 1 week after I noticed a pin hole leak in the incision .... hence I have to return in another week as it is still a small leak!
Have been on Antibiotics for a week and my stomach is like on fire!! Dr recommended Yogurt ... I have really no appetite so I’m Forcing myself to eat just a little!
The only real swelling is under the incision ... like fluid pocket the length of cut! Any ideas how to break that fluid build up?
Another question riding in a car with knee in slightly bent position is very uncomfortable are there any suggestions?
I’m trying not to bend knee too much as to give the incision a chance to dry up and heal in the weakened area!

Any help with the above is appreciated!!!
SusieB

 

[SusieShoes]

I'd be very leery of trying to break a build-up of fluid, or anything, near or around a still healing incision. Even though the skin is closed --but for the pinhole-- there is inflamed, angry tissue underneath that's producing this fluid. Pushing the fluid around would only aggravate that tissue and lead to more inflammation. Unless instructed by your OS or other doctor, don't attempt to push fluid out. This is a time to be patient.

Early days in the car (as a passenger), I would fold a firm regular or long size pillow in half and put it under my knee to help support it. Often I used ice packs while riding, so the support was extra welcome. I would also put my feet up on the duffel bag I used to carry the packs and other supplies, to lift my legs a bit. I assume you're already putting the seat back so you can stretch your legs more.

Yogurt is a good food for problems due to antibiotics. There are yogurt drinks, too, which can be a good change of pace. Check into probiotics, too, to help replenish your intestinal bacteria. I find when my tummy is bad, carbs are the easiest to eat: graham crackers, crackers, toast. Because I'm diabetic, I can't depend only on those (have to eat low carb), so when I had a bad tummy in recovery I also turned to protein drinks and chicken noodle soup, or just broth. Your body needs nutrients for healing, so do what you can to keep eating.

 

[sistersinhim]

The very best thing you can do for swelling is to slow activities down and ice and elevate toes above your nose. This allows the fluid to drain down to the kidneys and then passed out of your body through urine. I iced and elevated every time I sat or laid down for at least 2 months. I did have swelling, but it was minor.

 

[SusieB]

Can I ice over the Incision??? It is tender and Don’t know if it likes the cold??