The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Unicompartmental knee replacement => Topic started by: pegleg78 on December 28, 2005, 11:05:01 PM

Title: knee incision opened up almost 3 weeks post op
Post by: pegleg78 on December 28, 2005, 11:05:01 PM
I had a PKR on 12/8/05 and things have been going great for the most part.

Last night after I got out of the shower I was massaging my scar and I noticed the bottom inch or inch and 1/2 of the incision looked black. when I massaged that part it felt like there was a lot of fluid under neath and a gap under the skin. It was a really wierd feeling. Then a little tiny hole that showed up and started bleeding. I wiped it with a gauze pad and blood gushed out. It was bright red blood, it looked new, there were no clots. It filled 5 or 6 gauze pads and it was about 1/2 inch long and deep enough to see muscle. It was 5:15pm, so of course my OS office was closed. I had the on call physician paged (my OS is out of town for the holidays) and he never called me. So called back and they paged him again, still no call. It then got to be 7pm and I had called to have him paged 4 times, but he never called back. My therapy clinic was closed, but I did get a hold of the PT who did my home therapy. She told me to go to urgent care to get it resutured. The hospital I had surgery at is over an hour away or I would have gone to that ER.

Anyway after waiting 2 hours at urgent care, I did finally get to see the doctor. By that time the open part of the incision had tripled in size and depth. This made me very worried! He told me not to worry to let it heal from the inside out. He wasn't going to do anything for my knee. I was really worried because my OS had stressed how important it is to take antibiotics when you have an implant and any type of infection, or even any chance of infection. The urgent care doctor did page the on call doctor, and low and behold he called him back in 2 minutes. He instructed them to wrap the wound and start me on antibiotics, and have me come to clinic today at 10am.

I went to see my OS's PA who was also in surgery and has been doing my after care. He put some steri strips and wraps and told me to come back on Friday. He said that on Friday he can tell if I need to go back to surgery to have it closed, or if it will close with the steri strips. He told em to leave the dressing on today and change it in the morning.

I had therapy this afternoon and after my quad sets and heel slides my bandage was blood soaked. This is very concerning to me. I called the office to let them know, but they have all gone again and I have to deal with the on call os again tonight, and since he was so helpful last night I don't want to go through that again.

Has anyone had this happen to them after surgery? Any advice would be greatly appreciated!

Title: Re: knee incision opened up almost 3 weeks post op
Post by: Doc79316 on December 29, 2005, 08:53:03 AM
hi Melanie,

I had a similar problem a couple of years ago fter TTT surgery. The whole wound opened up. I had dissolvable stitches and I think they dissolved before the wound had healed enough to stay closed.
I was told the same thing - just to keep it clean, keep re-dressing it (as if it wasn't sore enough to begin with) and if it changed in appearance/character to go straight to A&E. I had to complete a course of wat I consider to be extrememly powerful antibiotics which knocked me for six. I was zombied out for a couple of days but managed to get through without having it re-stitched and without any infection either.
Maybe you should try not doing your exercises for a couple of days - then the wound may not open up quite so easily.
I wouldn't worry about it too much, just go with what your OS tells you for now. If the wound gets any bigger, bleeds a lot more to the extent where you can't stop it or changes colour etc then consider it an emergency and see a doctor straight away.
Hope this helps.

Laura. x
Title: Re: knee incision opened up almost 3 weeks post op
Post by: pegleg78 on December 29, 2005, 05:20:08 PM
Thanks Laura,

I appreciate the advice. It is good to know that it has happened to other people. I was really worried that it was a freak thing that doesn't happen. I will watch it and follow up with my OS as instructed. It has started to hurt a lot more today and is still bleeding quite a bit which has me worried. But I do have an appt tomorrow.

Thanks again
Title: Re: knee incision opened up almost 3 weeks post op
Post by: hopalongcasualty on December 29, 2005, 09:10:34 PM
Gawd  :-X You are a trooper.  I would have  :o FREAKED  :o out like WOW...

The OS's instructions sound reasonable.  I would also hold of on the exercises for a few days to let the skin knit some. 

I had a Maquet procedure in 89 and the wound took some time to heal he put in a triangle of "fish mouths" to let the skin expand and the doc had a drain in.  He used the one thread stiching that was removed several weeks post op.  snipped one end and then pulled the rip cord EEEEEEEwww what a wierd feeling but much better than when I had staples removed and they curled under tearing through instead of opening out.  The wound got an infection and ooozed for a while but eventually healed up. 

Please keep us posted. 


Title: Re: knee incision opened up almost 3 weeks post op
Post by: stgiles16 on December 30, 2005, 12:04:15 AM
I had something similar happenwith my abdominal surgery. right before I came home, I had a very large hematoma burst out of the incision. It freaked me out. There was blood everywhere. After cleaning the wound, the dr checked it, sent me home with instructions to keep it clean, dry and covered. It took weeks for mine to heal but eventually it healed and looks just like the rest of the scar. Please be very careful and keep a close eye on it. Follow instructions to the T . I really hope that you heal soon and well.

good luck
keep us posted.

I must admit, it was very gross but did get better.

Title: Re: knee incision opened up almost 3 weeks post op
Post by: amandalee on December 30, 2005, 11:49:48 PM
hey melanie!

i had a similar problem with my TTT/LR in august(2005)... but my wound still hasn't closed. after multibple rounds of antibiotics a few infections and everykind of wound dressing/ gel imaginable we have finally deided to try a cast. I have seen a wound care specialist, a plastic surgeon, and my OS non stop since the wound opened(about two weeks post op) . after everything we have tried i think the most sucessful was immoblizing it and staying off of it. I recommend that you stop your exercises and stay off of your leg. also, even if they tell you you can i dont recommend letting water run over it in the shower....that makes the skin weak and it opens up more.

p.s. if they say they want to take you back into surgery , ask them if you can explore your other options first....i had a biopsy with debridement and restucuring about three weeks ago, and i got really sick and the wound got worse.

good luck....and let me know what your dr. says!

Title: Re: knee incision opened up almost 3 weeks post op
Post by: pegleg78 on December 31, 2005, 04:36:05 AM
I saw the Physician Assistant today (my OS is still out of town), he has talked with my OS and thay have put me on the surgical schedule for Tuesday for what he described as a wash out and closing procedure. Although when he saw it today he said he thinks it will just heal on its own. It has been 48 hours since the steri strips were applied and the bleeding has stopped, but the pain has increased a lot. There is no redness or heat around the site, so that is a good sign. He said if it gets any worse over the weekend call him immediatly, otherwise they will make the determination of surgery on Tuesday. He told me It can be very serious if the infection gets into the joint and into the implant.


What other options do you think there are instead of surgery? I do not want to go back in surgery, but that is what the OS is recommending.

Thanks for all your help
Title: Re: knee incision opened up almost 3 weeks post op
Post by: amandalee on January 12, 2006, 04:06:50 AM
hey how are you doing? did you decide to have the surgery? is the wound still open?

let me know .... hope your feeling better


p.s. my wound finally closed all thanks to the cast with a silver dressing called silvasorb
Title: Re: knee incision opened up almost 3 weeks post op
Post by: hopalongcasualty on January 12, 2006, 04:19:13 AM
CONGATULATIONS AMANDA!!!  That is great to hear.
Title: Re: knee incision opened up almost 3 weeks post op
Post by: pegleg78 on January 12, 2006, 03:03:45 PM
I am so glad that your wound finally closed. I held off with surgery, my knee looks great. The steri strips came off and put new ones on. Things are going well with the incision. It is closed, but very tender to the touch. I am going again today and they will take off the steri strips again to check the wound. I;ll let you know how it goes.