Managing Blood Clots After Foot Injury: Expert Advice and Solutions - Surgery

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Dorsal foot contusion?


Hello Dr.
Hsu: On November 13, while working, I sustained a bruise of approximately 3 centimeters on the dorsum of my foot due to a metal plate impact.
After suturing, when I returned nine days later to have the stitches removed, I noticed swelling on the dorsum of my foot.
The orthopedic surgeon diagnosed a blood clot, and indeed, a significant amount of blood clot was found during the stitch removal.
It was thoroughly debrided, and a drainage tube was reinserted for suturing.
I have been returning daily for dressing changes, but the next day, the swelling persisted, and there were still blood clots.
This time, a compression method was used for clearance, and another drainage tube was added.
I continued daily dressing changes, but the blood clot issue remained.
The current physician indicated that a larger blood vessel was affected, leading to slower absorption of blood.
Therefore, the current approach involves placing a gauze in the area where the drainage tube was inserted to prevent blood accumulation in the dorsum of the foot.

Now, I would like to ask Dr.
Hsu two questions: 1.
The treating physician mentioned that my blood is more viscous and harder to absorb.
Are there any methods to improve blood viscosity? 2.
Besides the gauze insertion method, do you have any other recommended solutions? I have inquired about dietary issues with the treating physician, and there were no concerns; I also do not smoke.
I appreciate your guidance on these matters.
Thank you.

Shou shang de ren, 40~49 year old female. Ask Date: 2020/11/24

Dr. Xu Kaixi reply Surgery


1.
If the method you described is not effective, you may ultimately need to consider surgical debridement as a treatment option.

2.
The same applies.

Reply Date: 2020/11/24

More Info


Managing blood clots after a foot injury can be a complex process, especially when complications arise, such as swelling and persistent clots. Based on your situation, here are some insights and recommendations that may help you navigate your recovery.


Understanding Blood Clots and Their Management
Blood clots can form as a natural response to injury, particularly when there is damage to blood vessels. In your case, the impact from the metal plate likely caused significant trauma, leading to the formation of clots in the affected area. The swelling you are experiencing is a common symptom, as the body attempts to heal itself, but it can also indicate that the blood is not circulating properly or that there is an accumulation of fluid.


1. Improving Blood Viscosity
Your physician mentioned that your blood is "thicker" or more viscous, which can complicate the absorption of clots. Here are some strategies that may help improve blood flow and reduce viscosity:
- Hydration: Ensure you are drinking plenty of fluids, particularly water. Dehydration can lead to thicker blood, so maintaining proper hydration is crucial.


- Dietary Adjustments: Incorporate foods that are known to promote healthy blood flow and reduce viscosity. Foods rich in omega-3 fatty acids (like salmon, walnuts, and flaxseeds), garlic, turmeric, and ginger can be beneficial. These foods have anti-inflammatory properties and can help improve circulation.

- Regular Movement: If possible, try to move your toes and foot regularly to encourage blood flow. Gentle exercises, as tolerated, can help prevent further clot formation and promote circulation.

- Consultation with a Specialist: If your blood viscosity remains a concern, consider consulting a hematologist. They can evaluate your blood properties and may recommend medications or supplements to help manage viscosity.


2. Alternative Management Strategies
While the current approach of using a drainage tube and packing gauze is one method to manage the situation, there are additional strategies that could be considered:
- Compression Therapy: Depending on your physician's advice, using compression bandages or stockings may help reduce swelling and improve blood flow. This can be particularly effective in preventing further clot formation.

- Physical Therapy: Once your doctor approves, engaging in physical therapy can help strengthen the area and improve mobility. A physical therapist can provide tailored exercises that promote healing without putting undue stress on the injury.

- Monitoring and Follow-Up: Regular follow-ups with your healthcare provider are essential. If you notice any changes in symptoms, such as increased pain, redness, or warmth in the area, report these immediately, as they could indicate complications.

- Surgical Intervention: If clots persist despite conservative management, surgical options may need to be reconsidered. This could involve more invasive procedures to remove clots or to address any underlying vascular issues.


Conclusion
In summary, managing blood clots after a foot injury requires a multifaceted approach that includes hydration, dietary changes, and possibly physical therapy. It is crucial to maintain open communication with your healthcare providers and to follow their recommendations closely. If your symptoms do not improve or worsen, do not hesitate to seek further medical evaluation. Your recovery is paramount, and addressing these issues promptly can help ensure a better outcome.

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