Post-Surgery Complications in Diabetic Patients: Slow Healing and Persistent Fever

Poor wound healing after surgery in diabetic patients, persistent fever, and the use of antibiotics?

Hello, my mother has diabetes and recently underwent her fourth spinal surgery.
The wound is healing very slowly; it has been one and a half months post-surgery and is still not healed.
She has been experiencing nightly fevers, close to 38 degrees Celsius, occasionally exceeding 38 degrees.
Initially, we discussed with the doctor the possibility of switching to a stronger antibiotic, but he mentioned that a very strong medication has already been used.
Following the doctor's advice, she was examined by a pulmonologist to rule out tuberculosis.
I would like to ask: 1.
Given my mother's condition, would it be advisable to consult other specialties? 2.
My mother has been on long-term medication for diabetes prior to the surgery, and now she has been on antibiotics for one and a half months.
I am concerned about potential kidney damage, especially since she continues to have fevers.
Would it be better for her to be hospitalized for observation and receive intravenous treatment? Thank you for your assistance.

Una, 30~39 year old female. Ask Date: 2016/10/25

Dr. Liao Yaopan reply Family Medicine

Hello, regarding your inquiry, it is recommended to consult an infectious disease specialist to help assess the cause of the fever.
Due to the complexity of the condition, it is advisable to seek further medical examination and treatment.
Changhua Hospital cares about you.

Reply Date: 2016/10/25

More Info

Post-surgery complications, particularly in diabetic patients, can be quite challenging due to the interplay of various factors that affect healing and recovery. In your mother's case, the slow healing of her surgical wound and persistent fever are concerning and warrant a thorough evaluation.

Firstly, diabetes can significantly impair wound healing due to several reasons. High blood sugar levels can lead to reduced blood flow, which is essential for delivering nutrients and oxygen to the healing tissues. Additionally, diabetes can compromise the immune system, making patients more susceptible to infections. This is particularly relevant in your mother's case, as her persistent fever may indicate an underlying infection, possibly related to the surgical site.

Given that your mother has been experiencing fever for an extended period, it is crucial to investigate the source of the infection. While her current antibiotics may be strong, the presence of a persistent fever suggests that the infection may not be fully controlled. It might be beneficial to consult with an infectious disease specialist who can provide a more targeted approach to managing her condition. They may recommend further imaging studies or cultures to identify the specific pathogen causing the infection, which could lead to a more effective treatment plan.

Regarding your concerns about her kidney health, it is valid to be cautious, especially since prolonged antibiotic use can lead to renal complications. If her fever persists and her wound healing does not improve, hospitalization for closer monitoring and intravenous antibiotics might be warranted. This approach allows for better management of her condition, including hydration and monitoring of renal function, which can be more challenging in an outpatient setting.

In addition to consulting with an infectious disease specialist, it may also be helpful to involve a wound care specialist. They can assess the surgical site for any signs of necrosis or other complications that may be hindering healing. Sometimes, surgical intervention may be necessary to debride the wound or address any underlying issues.

Furthermore, it is essential to manage her diabetes effectively during this recovery period. Ensuring her blood sugar levels are well-controlled can significantly impact her healing process. This may involve adjusting her diabetes medications, dietary changes, and possibly increasing her monitoring frequency to prevent hyperglycemia.

In summary, your mother's situation requires a multidisciplinary approach. Engaging with specialists in infectious diseases and wound care, along with close monitoring of her diabetes management, can help address her complications more effectively. It is crucial to maintain open communication with her healthcare team, asking questions and expressing concerns about her treatment plan. This proactive approach can help ensure that she receives the best possible care during her recovery.

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