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Author Topic: weeping wound  (Read 6125 times)

Offline derek

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weeping wound
« on: August 17, 2002, 09:45:27 AM »
I'm 10 days post athroscopic surgery and my surgeon has not advised me (yet) of what went on in there. Today I had pain around the knee and above in the medial side of my thigh and below in the calf area. Which has now calmed.

One incision on the lateral side has been swollen and continually weeps. It's very tender compared to the other incision. Is it normal for fluid discharge to continue??

I've been searching various ortho web sites and am now aware that the knee is filled with saltwater or other like fluid during the op. Could it be this that's draining out?? Any answers
arthroscopy - so far , cellulitus infection

Iona_-Uk

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Re: weeping wound
« Reply #1 on: August 17, 2002, 01:27:24 PM »
Hi Derek and welcome to the board.

Fluid or any sort of discharge from the insicion must be investigated as this could be an indication of infection. Fluid within the joint post-op does not usually dispand through the scars although all things being said the surgeon who did my first operation did warn me that if I had an infection my scars may leak pus and/or fluid.

The pain you are experiencing may be due to the surgery, brusing in the tissues is not uncommon and indeed can be very painful or it could be an indication of fluid around these areas.

Wecan only speculate about itmight be but as you are experincing, pain and weeping I would strongly advise you consult your dr or surgeon so this can be rectified for you.

Good Luck.
Iona

Offline derek

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Re: weeping wound
« Reply #2 on: August 17, 2002, 01:48:22 PM »
thanks Iona

today I have spent searching the net, looking at knee sites etc etc and am coming to terms with it all, it's amazing what you can find if you try.

I'm not one to run off to dr's however I was tempted to go this morning but since the pain level subsided I thought I'd do some research of my own. This site seems to be an excellent avenue for "us" to get real information. I was disappointed my surgeon didn't make the effort.

As a novice to hospitals drs and the like I needed to be told something. I assumed that that was that and life resumes again. I was at work the next day off crutches a couple days later and off to watch the football that weekend. I read that 7 days recovery are recommended in most cases, but not being told hey..assume the best!!

With the incision it has not closed together well although it is healing, the discharge is pinkish and not as viscous as blood or pus and having sat relatively still at the pc today it has dried up a little also.

Could be I'm overdoing it a bit?

Seems you've had quite a go with your knees! All the best.

derek
arthroscopy - so far , cellulitus infection

Iona_-Uk

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Re: weeping wound
« Reply #3 on: August 17, 2002, 03:17:14 PM »
Hi again Derek.

It could be that you might have over done it a bit as I had setback after my most recent surgery even though I had very little post op pain and could feel the difference almost immediately post surgery in my knee.

I think you should make an appt with your dr or surgeon for sometime in the wwk, hey you can always cancel it if you find it is getting better, which is what I have done in the past.

Have you ben given an appt with a physio or a date to return to see the surgeon?, if your return visit was imeninant just wait and see what he says then.

Watch out for fevers as well as this wold indicate something not right.

I am so glad that I found this site and yes I agree dr's do not try hard enough to give their patients enough information, luckily my latest surgeon was great he told me what to expect, when and whything s would happrn and I will shortly be going back to see him to have the same things done on my left knee.

Maybe if dr's had a look on here they could re-dress their attitudes towards patients?

All the best to you as well
Iona

Offline Heather M.

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Re: weeping wound
« Reply #4 on: August 17, 2002, 10:19:36 PM »
Derek,

I've had 4 scopes, and after all of them had problems with wound closure and drainage.  The last three times I've gotten an infection--basically normal skin bacteria that live with you every day entering the knee through the incision and making themselves at home, which is disastrous for the knee.  As long as the bacteria are in there, the incision won't close. Some post-op drainage is normal, but usually in the first few days.  

Here's what my doctor instructed me to do during these episodes:  clean the knee with STERILE alcohol wipes, put sterile gauze pads on the incision, and use an ACE bandage/tensor to keep the gauze in place and provide some compression. Elevate, ice, and stay off the leg as much as possible.  Bend as little as possible, because bending opens things up. Change the gauze up to 4 times per day, always noting how much drainage there has been and what color the fluid is, and if the color or consistency has changed at all.

I've had these wounds drain for varying amounts of time:  2 days (then it closed on its own), 1.5 weeks (then it got infected and I had another surgery  :'(), 5 days (switched antibiotics and that did the trick), and 3 weeks (two different antibiotics and an aspiration plus a week of complete bed rest before it closed).  

I strongly recommend that you contact your doctor as soon as possible.  He or she may want to put you on prophylactic antibiotics or see you/speak with you on a daily basis to monitor things.  As my surgeon said to me--if stuff can get out of your knee, stuff can get in.  You've got to watch it carefully.  Believe me, you DO NOT WANT TO GET AN INFECTION. It will mess up your recovery in ways you can't even imagine and can cause long term complications that will make your knee miserable.

Take care of that knee and don't hesitate to call the doctor or visit the emergency room if you have a bad flare up.  Warning signs to look for, like Iona mentioned, are fever, night sweats, chills, redness, puffiness, red streaks on the leg (I had that last time--sepsis, not fun at all), yellow or cloudy drainage, and throbbing pain that you can count your heartbeat in (kind of like a bad tooth).

Good luck and let us know how things go.

Heather

Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Iona_-Uk

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Re: weeping wound
« Reply #5 on: August 17, 2002, 10:39:14 PM »
Something I forgot to mention when I had my haem I also had what dr's considered a minor infection but I didn't realise it, the give away sign for the dr was red streks on my thigh and ankle where the increased blood flow was.

Your dr may well want to cover you with antibiotics but Helen has given you some great tips to try to help.

One thing though, don't press the gauzes onto the wound to hard, like I've done, because it makes it very sore, just tape with micropore or similar enough to let the wound breathe but not enough for the fluid to escape and do make that appt for your dr.

Iona (again!)

Offline derek

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Re: weeping wound
« Reply #6 on: August 20, 2002, 06:26:53 AM »
You girls should be MD's !  :D

The following day (Sunday 18th) I couldn't walk on the leg and was in excrutiating pain. So as I live on my own (this is becoming a hassel in post op care) I drove myself to the main Emergency Hospital which is not far from where I live and after the usual delays experienced in these waiting rooms had a dr look at the leg which was almost 1/3 more enlarged very very tender and red coloured from the upper knee to ankle.

The diagnosis after blood tests etc was cellulitus. My temp got up to 38.4 and yes I had those chills & sweats and felt weak and ordinary! My white cell count was off the scale and my lymph gland in the groin was working overtime. They organised for me to be admitted to a hospital opposite the surgeons rooms. I was on antibiotic drips and penicillin over a 24 hour period after which the redness & swelling had subsided enough for them to discharge me with a pack of flucocillin antibiotics and after the surgeon paid a flying visit and okayed me to be discharged later that day.

My calf had become a little looser and walking was almost quite easy when I left (I was thinking miracle cure and thanked the nursing staff profusely). The wound that had remained open had closed substantially and the swelling around it almost gone which was redressed with waterproofing. However when I got home the wound had obviously opened again which was visible by discharge under the dressing.

The next day (today) the swelling was back up and tenderness had resumed on the skin surface. Having 2 cats even them rubbing against my legs as cats are want to do was painfull. I am contemplating a return visit to the hospital but I might just see if the antibiotics kick in again today.

Derek
arthroscopy - so far , cellulitus infection

Offline Heather M.

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Re: weeping wound
« Reply #7 on: August 20, 2002, 07:08:25 AM »
Derek,

I'm so sorry you got cellulitis.  That's what I had happen to me last time, only my infection was concentrated at the base of my quads and spread from there to below my knee.  Cellulitis really feels horrible and the pain is very intense--icing and elevating should make you feel much better.  I also had excellent success with the ace bandage/tensor to keep a bit of pressure on the gauze and keep things from ballooning.  Of course you should follow the hospital's instructions for your post-op care.  Don't be alarmed if it seems that the incision is still draining a bit, especially after moving around.  I had mine close up almost from one hour to the next after about 4 days on antibiotics.

I was put on Levaquin (levofloxacin sp?), which is a relative of Cipro (ciprofloxacin), as I am allergic to penicillin.  I can't say enough about these new generation antibiotics--within 2 days I began to feel ok, within 72 hours I was 100% better. Night and day.

You'll see, it will really improve by tomorrow.  As quickly as you began to feel horrible, you'll start feeling better.  If not, call your doctor and see what he says.  You may have to try a different antibiotic, but whatever they gave you should really kick in by Tuesday at the latest.  Once you get this behind you, talk to your doctor about a rehab protocol.  It's very important, once the infection clears up and the incision is healed, to get your knee moving again.  That will be the best thing for your recovery.

Take care and be nice to your poor traumatized knee.  This may slow your recovery a little, but I've managed to get past the worst of it and am seeing improvements.

All the best,

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
2006 Arthrofibrosis, patella baja
http://www.flickr.com/photos/hmaxwell

Offline derek

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Re: weeping wound
« Reply #8 on: August 20, 2002, 08:00:13 AM »
Thanks Heather glad to see I should make a recovery.  ;)

I'm just about to have another antibiotic pill and I should go to the pharmacy to get painkillers which I have neglected to do. I always thought they were a bit wussy and didn't do much for pain releif anyway but I'm keen to try now !!

I have been checking www for cellultius and other than bulletin bd type question/answers which are hard to link (for me) haven't found a great deal. However one site (Merck) gave a fairly basic outline of what it is etc. It did say that a recurrence can appear quite soon after commencing the treatment due to the sudden death of bacteria some new enzymes are produced that I interpreted as meaning these imitate the bacteria then subside. So I have taken heart by you thinking all might turn around tomorrow.

Lucky for me I have no allergies so its gung ho with the penicillins for me and I'm told there is no infection in the knee joint which is moving now relatively well with no discomfort other than some mild occassional aching. Must say my right knee seems to be aching in sympathy too, not sure about that one  ???

I'm not sure about changing dressings etc as they say to leave the waterproofing on for around 4-5 days.

Lets see what tomorrow brings  8)
arthroscopy - so far , cellulitus infection

Iona_-Uk

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Re: weeping wound
« Reply #9 on: August 20, 2002, 10:15:05 PM »
Oh Derek, poor you, cellulitis is terrible.

I've had it after having an injection and I can honestly say it was the vilest thing I have ever had.

Make sure you take those antibiotics regularly and keep you leg elevated and if you can bear it wrap a bag of something frozen in a towel and place it on your leg.

Have they told you to change your dressings at all, if you feel uncomfortable, remove them briefly and replce with clean ones making sure you keep the area as sterile as possible.

If you get more pain or fever go back and see the emergency room or on call GP, but don't be afraid of wasting peoples time, cellulitis is stubborn, believe me,and you may need a combination of antibiotics to clear it up properly and you may be on them for 3-4 weeks but hopefully the antibiotic they gave you in hsopital would have killed off the bacteria in your blood stream casuing the problem.

Fingers crossed.

iona

Offline derek

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Re: weeping wound
« Reply #10 on: August 21, 2002, 05:45:08 AM »
Iona it is quite vile!!!

I'm pretty sure the antibiotics I have are not doing there stuff or something as the swelling is still up and is now obvious around the ankle and foot as well as around my calf/shin/knee. The wound has reopened again as I suspected so I shall have to drag myself out to the chemist for some dressings etc. Amazingly the medial side wound has closed and healed wonderfully and is almost unnoticeable.

I guess the antibiotic drip in hospital is super strength therfore the quick response in reduction of swelling-pain-redness. The redness which (I had) I would describe as a uniform colour is now a blotchy purply colour there are a couple of small blister marks and the lower leg looks like the capilliaries have been crushed to the surface, not pretty. I might go to the GP today as well incase I can get some stronger antibiotics.

thanks for your support, and how are you getting on?

derek
arthroscopy - so far , cellulitus infection