Postoperative infection of the wrist?
Hello Doctor, I had surgery for a wrist fracture on October 4th, and titanium alloy was used.
I was hospitalized for three days.
I returned for a follow-up on October 16th, and my recovery was good.
The doctor said I could shower and use adhesive tape, but I wanted it to breathe, so I didn't use the tape while showering.
Over the past two days, on October 28th, I noticed that the sutured area is healing normally, but there seems to be a small hole near where the doctor tied the knot, which is red, swollen, and has pus.
I squeezed out the pus, but it is still red and swollen.
Why hasn't the wound healed well after so many days? Could this lead to osteomyelitis? Would not using the adhesive tape cause this? How long until I can get the area wet? I'm very afraid it might develop into cellulitis; would that require another surgery? How should I manage the wound?
Xiao Mi Hu, 50~59 year old female. Ask Date: 2023/10/30
Dr. Shi Guozheng reply Orthopedics
1.
Timely intervention may prevent osteomyelitis.
2.
It is unrelated to adhesive tape.
3.
The wound can only be exposed to water after it has healed.
4.
The wound usually improves after drainage.
Reply Date: 2023/10/30
More Info
Post-surgery wrist infections can be a significant concern, especially following a procedure like wrist fracture repair with titanium alloy fixation. It’s understandable to feel anxious about the healing process, particularly when you notice symptoms like redness, swelling, and pus around the incision site. Let’s break down your concerns and provide some insights into the symptoms, potential complications, and recovery timeline.
Symptoms of Infection
Infections post-surgery can present with several symptoms, including:
1. Redness and Swelling: This is often the first sign of infection. If the area around the incision is red and swollen, it may indicate inflammation or infection.
2. Pus or Discharge: The presence of pus is a clear sign of infection. It’s crucial to avoid squeezing or manipulating the area excessively, as this can worsen the infection or push bacteria deeper into the tissue.
3. Pain: Increased pain at the site of surgery, especially if it worsens over time, can be a sign of infection.
4. Fever: A systemic response to infection may include fever, although not all infections will present with this symptom.
Concerns About Complications
You mentioned concerns about developing osteomyelitis (bone infection) or cellulitis (skin infection). While these are valid concerns, they typically arise from untreated infections or complications from surgical procedures. Here are some points to consider:
- Osteomyelitis: This is a serious condition that can occur if bacteria enter the bone, often requiring prolonged antibiotic treatment or surgery. If you experience persistent pain, fever, or worsening symptoms, it’s essential to seek medical attention promptly.
- Cellulitis: This is a skin infection that can occur if bacteria enter through a break in the skin. It can lead to systemic symptoms and may require antibiotics.
Recovery Time and Management
The recovery time after wrist surgery can vary significantly based on several factors, including the extent of the injury, the type of surgery performed, and individual healing rates. Generally, the following timeline can be expected:
- Initial Healing: The first few weeks post-surgery are critical for healing. During this time, it’s essential to keep the area clean and dry. If you have a small opening or drainage, it’s crucial to monitor it closely.
- Follow-Up Care: Regular follow-up appointments with your surgeon are vital. They can assess the healing process and determine if any interventions are necessary.
- Bathing and Water Exposure: Typically, you should avoid submerging the surgical site in water until it has fully healed, which can take several weeks. If your doctor advised you to keep the area dry, it’s best to follow that guidance to prevent infection.
Recommendations
1. Keep the Area Clean: Gently clean the area with mild soap and water, avoiding direct water pressure on the incision site. If there is an opening, it may need to be covered with a sterile dressing.
2. Monitor Symptoms: Keep an eye on the symptoms. If the redness, swelling, or discharge worsens, or if you develop a fever, contact your healthcare provider immediately.
3. Avoid Squeezing: While it may be tempting to squeeze out pus, this can lead to further complications. Instead, allow your body to naturally expel any discharge.
4. Consult Your Doctor: Given your concerns about potential complications, it’s advisable to reach out to your surgeon or healthcare provider for an evaluation. They may want to perform a physical examination and possibly imaging studies to assess the situation.
In conclusion, while post-surgical infections can be concerning, prompt attention and appropriate care can help manage the situation effectively. Always prioritize communication with your healthcare provider to ensure a safe and smooth recovery process.
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