Incision on chest not healed completely.

[ATHENS1964]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897101/

 

[Amy]

Thanks.

I wonder how much platelet-rich plasma increases your INR?

Or maybe that’s the least of one’s worries when you have an open incision as bad as those patients’...

if I could just get a straight answer on what to do to heal it - whether to cover it or not, and if so, what kind of dressing or gauze is best; whether it’s worth buying supplemental zinc or arginine; whether to wash up every time it seeps, or keep it dry at all costs, even avoiding sweating, showers, any humidity..... every single doctor tells me something different; then articles and scientific papers I find contradict what the doctors said.

I’m doing a ‘virtual visit’ with a cc surgeon tomorrow, since the nurses gave me the runaround, and wouldn’t just call me back with some simple advice. I really, really hope that he doesn’t spend half the time confirming info I’ve already provided & the other half spouting generalities. Oh please don’t let that happen...

 

[Amy]

Well, he took one look at it (over zoom) and said it’s infected.

As if this wasn’t bad enough, his next sentence was that it was infected because of the sternal wire, and I need surgery to remove one or two of them.

When I questioned him he admitted oral antibiotics could possibly heal it.

SoI’m on Keflex for a month.

So many questions - why did my cardiologist look at my incision and say it was fine? At my CT and say there was no infection? My surgeon’s office has had my CT for an entire month, and never said a thing.

What is the likelihood the infection will go away without another surgery? Is there anything else I can do to help my immune system beat it? Does anyone have any research about this? I’m having trouble finding anything. The surgeon had no information about anything non-surgical-related.

Any search of ‘superficial sternal wound infection’ brings up way worse photos I can’t handle looking at right now.

 

[Amy]

Wow, look at this:

https://pubmed.ncbi.nlm.nih.gov/24851729/
Too late...

 

[Amy]

I found this:
https://www.woundsme.com/uploads/resources/content_9823.pdf

 

[tom in MO]

Well, he took one look at it (over zoom) and said it’s infected.

As if this wasn’t bad enough, his next sentence was that it was infected because of the sternal wire, and I need surgery to remove one or two of them.

When I questioned him he admitted oral antibiotics could possibly heal it.

SoI’m on Keflex for a month.

So many questions - why did my cardiologist look at my incision and say it was fine? At my CT and say there was no infection? My surgeon’s office has had my CT for an entire month, and never said a thing.

What is the likelihood the infection will go away without another surgery? Is there anything else I can do to help my immune system beat it? Does anyone have any research about this? I’m having trouble finding anything. The surgeon had no information about anything non-surgical-related.

Any search of ‘superficial sternal wound infection’ brings up way worse photos I can’t handle looking at right now.

why did my cardiologist look at my incision and say it was fine? At my CT and say there was no infection? The cardiologist is not a specialist on your surgical wound. This is the surgeon's area of expertise. It was made clear to me by the cardio and surgeon that the surgeon had the ball until I was released. The cardio was a consultant. After release by the surgeon, then the cardio was in charge.

My surgeon’s office has had my CT for an entire month, and never said a thing. This is wrong. You may want to pursue this, if only to have cc and this surgeon change their ways for the next patient.

I had my surgery at a local hospital that has integrated cardio care. For my surgery I had two appointments post surgery, one with the surgeon's PA and the last with the surgeon to assure my healing was going well. I had a chest Xray for surgical release to work.. They made a point of telling me the wires were in good shape. In addition to the surgeon and his staff, my wound was examined weekly by the head nurse at my post-op cardio rehab clinic. She gave me adhesive removal for some of the gunk that was hard to remove and held my hand when I was concerned it took time to heal.

For this problem, if Keflex doesn't work, I'd suggest asking your cc surgeon for a local referral, unless you plan on returning to Ohio. Make sure he assess your Xray to assure the wires are behaving properly.

You are a strong woman to remove your OHS sutures. I am impressed You remind me of a friend who got tired of itching and cut himself out of a cast with an auto body saw. He was right, cast wasn't needed anymore.

 

[Chuck C]

When I questioned him he admitted oral antibiotics could possibly heal it.

SoI’m on Keflex for a month.

Hi Amy.
Any improvement on the wound since going on Keflex?

 

[Amy]

Thanks, Chuck & Tom.

So it is 3 1/2 months post-op, and 2 weeks on antibiotics for what a thoracic surgeon said is a superficial sternal wound infection; but he also said he suspects two of the sternal wires are infected, which sounds to me like maybe something different?...

I feel occasionally every day a sort of burning sensation I didn’t feel before, about a half inch or so below the skin surface, in my chest and also on my side under one breast where the chest tubes were. Is this a sign the antibiotics aren’t working? Just wondering if anyone with experience in this knows.

How many more CTs can I expect to have to have to make sure it’s not still infected? Can I suggest an echo instead, would it show up? Should I be exercising like mad to boost my immune system, or saving energy so the body can fight the infection?

Thank you in advance, & hope everyone’s doing well.

 

[Amy]

Tell me about your infection experience!

It’s been over a week since stopping Cephalexin and I’ve been waiting and hoping and so far the incision/wound hasn’t opened again, thank goodness, despite a small scab having formed over where it had opened before.

I managed to get an appointment with a surgeon here where I live for later this week, which I made weeks ago just in case it opened up... and now I’m wondering if he’ll even be able to say anything without anything to see or culture. What scans did you all have to detect infection? (The surgeon at CC who had my CT for a month and never told me I had an infection said CTs aren’t that good at detecting infection, and that they don’t HAVE a good test for detecting them... so frustrating - why then did my cardiologist order one??) What I don’t want to do is miss finding a smoldering infection and only realize it once it’s got really bad.

I still have aches and pains in my sternum, chest tube holes, incision, on and off throughout the day; and some burning or itching sensations I never felt in the first three months post-op.

For those who had an infection, were there any other symptoms besides wound opening / drainage, and redness (and fever or chills) that, looking back, you now see was a sign?

Is there anything I could ask a doctor to do to help me find out if there could still be an infection in there?

Any information would be appreciated.
Thanks.

 

[Unicusp]

Hey Amy. Sorry to hear. The tell tale sign to me are the mentioned aches, pains, burning, itching symptoms. In my opinion you should be past that stage. To me that sounds like an internal infection.
I suggest you keep your appointments and get this resolved quickly. The medical professionals should know what to do next.
I wish you luck. Hang in there! Let us know how the appointment goes. Take care.

 

[Chuck C]

For those who had an infection, were there any other symptoms besides wound opening / drainage, and redness (and fever or chills) that, looking back, you now see was a sign?

Thanks for the update Amy. Sorry, I can't help here, as I don't have any experience with infections. Hopefully, if there was an infection, the antibiotic cleared it up.
Please keep us posted and you are in our thoughts.