Post-Surgery Redness and Swelling in Orthopedic Wounds

Surgical wound redness and swelling?

Hello, doctor.
In early September of this year, I suffered a closed fracture of my left ankle due to a work-related accident.
I immediately sought medical attention and underwent surgery, during which steel pins and plates were inserted.
After the surgery, I was discharged and rested at home.
I later had my stitches removed, and the external injuries from the fracture and the surgical wound had mostly healed.
However, around the end of October, I suddenly noticed a small wound emerging at the site of the surgical stitches.
Initially, I thought I might have accidentally injured it while sleeping.
I continued to clean the wound with saline solution and applied the antibiotic ointment prescribed by my doctor, covering it with a bandage as usual.

Now, half a month later, although the small wound has gradually become shallower, it still hasn't healed.
Additionally, there are new tiny wounds appearing around it, resembling abrasions.
The surrounding skin, which was originally red and swollen, now feels darker in color.
Since it is very inconvenient for me to go out due to my fracture, I would like to ask you, doctor: should I return to the hospital for a consultation, or is it normal for healing to take longer? Thank you.

Mr. Zhang, 20~29 year old female. Ask Date: 2022/11/12

Dr. Wang Shouji reply Orthopedics

Hello, it has been two months since the surgery at the beginning of September, and the wound still appears somewhat abnormal.
It is still recommended to visit the hospital for further evaluation.
Changhua Hospital cares about your health.
Sincerely, Wang Shou-ji.

Reply Date: 2022/11/12

More Info

In the context of orthopedic surgery and wound healing, it is not uncommon for patients to experience redness and swelling around surgical sites, especially in the weeks following a procedure. However, persistent or worsening symptoms can indicate underlying issues that require further evaluation.

From your description, it seems that you had a closed fracture of the left ankle, which was treated with surgical intervention involving the placement of screws and plates. After the initial healing phase, you noticed a small wound emerging at the site of the surgical incision, which has not healed despite your efforts to care for it with saline and antibiotic ointment. The surrounding skin has also changed in color and texture, which is concerning.

Redness and swelling can be part of the normal healing process, particularly if there has been any irritation or minor trauma to the area. However, the fact that you are experiencing new small wounds and a change in the color of the surrounding skin suggests that there may be more going on than just a slow healing process. These symptoms could potentially indicate an infection, delayed wound healing, or even the formation of scar tissue that is not healing properly.

Infections can manifest as redness, swelling, warmth, and sometimes discharge from the wound. If the area is becoming increasingly red, swollen, or painful, or if you notice any discharge that is yellow or green, these could be signs of an infection that requires medical attention. Additionally, the presence of new small wounds around the original site could suggest that the skin is breaking down, possibly due to pressure, friction, or inadequate blood supply to the area.

Given that it has been over half a month since you first noticed the small wound and it has not healed, it is advisable to seek medical attention. You should contact your healthcare provider or return to the hospital for a thorough evaluation. They may want to assess the wound for signs of infection, evaluate the healing process, and possibly perform additional interventions such as debridement, a culture of any discharge, or a change in your treatment plan.

In summary, while some redness and swelling can be normal post-surgery, the persistence of your symptoms, especially the emergence of new wounds and changes in skin color, warrants a professional evaluation. It is always better to err on the side of caution when it comes to potential complications following surgery. Your healthcare provider can provide you with the best course of action to ensure proper healing and to address any underlying issues that may be present.

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