Portal Not Healing

[JG]

All,

I had a scope and nerve decompression surgery on Wednesday.  I went to see my PT today and she wanted to see me contract my quad.  Keep in mind I have some bandages over my scope portal (simple band aid type, but sticky stuff on all sides).  When I contracted my quad the bandage got dark.  She asked me to do it again, now the bandage became soaked.  Thinking it was blood (I'm on heparin and coumadin for history of DVTx2), they put a pressure bandage on it.  After waiting 30 minutes, it had seeped through the pressure bandage.  It wasn't blood, but synovial fluid with a tinge of blood.  Great!  So we took off all the bandages and she had me do another contraction.  Synovial fluid spurted out of the portal, about 4 inches above the skin.  Neither of us could believe our eyes.  So she was able to contact me physician who wants me in immediately on Tuesday morning.  He mentioned that if it is really that bad, then he might want to wash it out (like I have an infection)  and re-surture in the OR.

Anyone have any experience with this?  Any advice would be helpful.

Janice

[stgiles16]

good luck with your appt and let us know how it goes.

missy

[hottubpam]

Hi Janice,

I had the same problem with my portal healing - twice this year.  Each time the OS put me in the hospital and did a ebridement, irrigation & lavage, and portal primary closure.   I had IV antibiotics for 1-2 days and remained in the hospital for 2 days for pain management and administration of antibiotics.

Your OS sounds like he is planning siimilar treatment.  If so, for me it was just "a bump in the road" on the way to recovery.

Good Luck,
Pam

[JG]

Pam, I was hoping you would comment.  Were you less than a week post-op when he decided to debride, irrigate, and close?  I was just telling a friend.  The look on the my PT's face when it gushed out was like an alien popped out of my knee.  The interesting thing is, I really didn't notice any leaking from the portal.  It was just when I contracted my quad that the fluid squirted out.  I did one quad hold and that was it.  Actually, I could believe the amount of fluid that came out.  I didn't think there was that much synovial fluid in the knee.  Granted it was somewhat bloody.   Even though I've had many operation, I really don't like the anesthesia part.  Last week wasn't bad, the last year I had a scope and it took me three days to wake up.  I would really prefer not to have to go back to the OR.

Janice

[hottubpam]

Hi Janice,

I was over 1 month post op when the portal opened up the first time.  It was after I had put a lot of stress on the knee, helping my Dad load his RV for his winter trip to Arizona.  I had also had a cortisone shot 3 weeks prior to the portal opening up.  I was also AMAZED at how much synovial fluid leaked and the portal became a hole producing a horrible sucking sound.  OS called it a "sinus tract".   The second time the portal opened it was just 2 weeks after the first surgery to close the portal and just a couple of days after the stitches had been removed.

Both times, my OS treated this as pretty much an emergency and got me into the OR within a day of seeing him.  He was very concerned about possible infection - although I did not develop an infection.  I didn't have much blood in the leakage, especially the second time it was just pure yellowish synovial fluid.

I don't mind the anesthesia part, although I don't like starting PT and rehab over after each surgery. 

I have to run - playing golf with my dad.  Please feel free to ask any more questions.  My advise is to follow your OS's advice, this is not a matter to be taken lightly.

Good Luck,
Pam

[JaneB]

I had  my portal leak too, although about a month after surgery.  It had scabbed over and when the scab came off there was a hole there.  My OS just sutured it up on an outpatient basis, with a novocaine injection (that hurt!).  The sutures were taken out about two weeks later and I've been fine.

JaneB

[JG]

Thanks Pam, Missy and Jane (I was hoping to hear from you as well). 

So I just got back.  The fluid seems to be a combination of synovial fluid (from sinus tract as Pam mentioned) and a hematoma (mostly pre-congealed which is not a surprise since I'm on heparin and warfarin).  He was really surprised by the amount of fluid that came out and was glad my PT called him late yesterday.  The amount that came out today was about 1/4 or 1/3 of what came out yesterday.  When I first showed him the fluid, it looks like it started to congeal a little.  He compressed my whole knee while I contracted my quad for like 5-10 minutes.  The stuff just didn't stop coming out.  It was basically a clear orange (clear-yellow synovial fluid and blood combined).  He then put a suture in and compressed/contracted again.  More fluid came out.  So he put in another suture and it only leaked a little.  So we decided to leave it until Monday.  If on Monday, I have any fluid, then I will go to the OR on Tuesday morning.

Hopefully on Monday I will be just fine...no leaking.

 

[Nettan]

Hey !!

hope everything's ok at monday.Wish you the best !!

Hugs nettan 

[brattkids]

Janice,

I will be praying that no more fluid is there!!!
Best of luck

Paulette

[hottubpam]

Hi Janice,

I'm kinda surprised he just sutured it up and sent you on your way.  Did he take a sample for a culture?  Did he put you on any antibiotics?  Watch your knee VERY carefully and if it gets hot, red or you start running a fever get ahold of your dr. or go to an ER.

Keep us posted.  I'll light a candle for your knee.

Pam

[JG]

Actually, I was kind of surprised as well.  He didn't take a sample for culture and no antibiotics.  I'm certainly going to keep an eye on it.  He mentioned that he didn't use a tourniquet due to my history of DVT so that is a strong potential reason for some of the fluid.  He did say that if I saw any problem that I should call him even if it's midnight (have his mobile).  I can already tell that fluid has accumulated again.  If I see leaking on Friday, I'm going to call him.  I think I'm okay in terms of infection.  Everything looks really good.

Thanks Pam!

Janice