Day 10 Post OP - Stitches or Staples?

I was never told what they had put my wound back together with after my op. I have read and seen pictures on here of both. I have stitches in wounds before and always had the itching/tugging feeling a few days before they are due to come out and I am  getting that now. I go back on Monday for my first post op consultation and I guess I find out then.

One thing I have not read about though is dissolving stitches being used in the main wound, I know they use them on the internal stitching but have not read anywhere if they are use on the external. Has anyone had this?

 

12 Responses to “Day 10 Post OP - Stitches or Staples?”

  1. Daz,

    All my stitches were dissolving, apart from one internal stitch which refused to dissolve, at one stage they thought I would have to have the wound opened up, but my physio suggested leaving it a few more weeks, which we did and one day I realised I no longer had the stabbing and stinging pain and swelling, so we presumed it had ginally gone.

    I did a brief synopsis for you of my injury timescale not sure whether you got it or not.

    Having a day off work today to do some much needed decorating which I started way back in March and haven’t been able to finnish. It has been driving me mad looking at a half done room so although I know I will be exhausted at the end of the day I will have achieved one of my goals.

    Annie

  2. dazf: My first surgery, I had dissolvable stiches on the outside and (unkown to me) NON-DISSOLVABLE stitches put in my Achilles. My second surgery, 2 years later, I had dissolvable ones put on the inside and non-dissolvable ones put on the outside. One of the things my second surgeon had to do was take the old stitches out of my Achilles. He said my body was rejecting the material (ethabon?) they were made out of and told me that if I ever needed stitches again to not let anybody use that material. I was upset that the first surgeon had used non-dissolvable stitches inside my Achilles anyways but I was told that some doctors use them if they are worried about the repair holding and they are not confident in performing any kind of a graft. If I were you, I would specifically ask what was used inside your Achilles. It could affect you later. Oh the things you learn with this injury.

  3. Question about Smish’s comment:
    I had dissolving stitches on the external wound with my first surgery…my body didn’t like them and I had two further surgeries for wound complications. The wound is finally closing now at about 12 weeks with the use of regular stitches in the external wound that needed to be removed after three weeks.
    My understanding was that all stitching of the actual AT was done with a permanent kevlar-type material.
    My question is what other type of surgical repair is made to the AT? A graft using another tendon? My father is a retired orthopedic surgeon, and he seemed pleased with the procedures used to repair my AT.
    hilary13

  4. hilary13: I am not sure if you are asking about the type of sutures used or grafts. There are two types of grafts(that I know about). One is using a tendon that runs through your big toe. If a lot of that tendon is needed, there will be a separate incision on the side of your foot. If just a little of that tendon is needed the surgeon can actually take it through your Achilles incision. The other type of graft can be done with something called a graft jacket. My understanding is that it is either from a cadaver or a pig (I think but not sure). After your Achilles is sewn together the doctor sews this “jacket” around your tendon to give you more of a tendon. I am not a doctor. This is just information I think I understood from talking with many doctors about my situation. Your dad would probably know a lot more except that I heard the graft jacket technique is fairly new. What I was saying in my post was that I had different kind of sutures in the two surgeries I have had. My doctor led me to believe that the non-dissolvable stitches are not the best choice for going inside the Achilles. Either way, it was a bad choice for me. I had NO wound problems with either of my surgeries. In fact, both times the doctors and nurses were amazed. My last surgery was 10 weeks ago and about 1/2 of my 8 inches of scars are already faded and look about 5 years old.

  5. Thanks, Smish.

    Your post made me curious, so I did more googling, and found some references to the procedures you are talking about, but nothing that specific. Thanks for the details.

    I had a moment of panic wondering if something different could/should have been done, but really don’t want to go there! I have a medical condition that makes some grafts difficult (I self-donated my own patellar tendon for an ACL repair a couple of years ago rather than risk using a cadaver donation) so while the big toe tendon might have been a possibility, I think my surgeon did what he thought was best. He’s been in there three times now, so I think if he wanted to do something differently he had the chance!

    I am glad to hear about these new procedures, however, as I think we are all our own best advocates for better health care in general.

    So, did you have the second surgery because you re-ruptured, or because the original internal stitches were causing problems for you down the road? Sorry if you have already explained that elsewhere on this site. And what kind of repair did you have the second time? Did you have only a graft? Was it applied with dissolving stitches? Did the repair require stitches of any kind? Just curious as I have a bump where I imagine the stitches in my AT are under the skin, and it is a little weird. I hope it won’t feel like this forever. And I do have a problem with the way I visualize the repair and how strong it is…I get a bit queasy when I think about stressing that stitched area, and a possible re-rupture at that site.

    Too much thinking I know, but hard not to.
    hilary13

  6. hilary13: My complete rupture and first surgery was July 2006. I have had tendonosis/tendonitis for about 12 years. The surgery went relatively well with a few issues (long story but I will try to figure out how to shorten it). Because of continued problems, I ended up with a foot and ankle orthopedist/specialist this Spring. New MRI and tests showed multiple new tears in my Achilles. It turned out that I needed to have my Achilles lengthened (not enough dorsi-flexion) and debrided (sp?) I also had to have my heel bone shaved down and bursitis removed. While the doctor was in there, that is when he saw the old sutures and saw the inflamed/infection around them. He said most people can have permanent sutures. My body just didn’t like them. While I was waiting for my surgery date, I did a partial re-rupture. I have to have my other Achilles lengthened as soon as I can take another Achilles surgery. My doctor said the, tendonitis then rupture, cycle would probably continue unless I had my Achilles lengthened. I use to walk and run on the outside of my feet and toes. It just finally caught up with me in my 30’s. My right leg got lengthened first because it was in the most trouble. My left leg is hurting pretty bad too. I have not yet ruptured my left foot. Sorry for the long explanation. When do you start PT? I bet your PT will be able to help you with your scar.

  7. hilary13: I forgot to mention; I was told that I would probably get the tendon graft going in to surgery but to my sheer delight, the doctor decided it was not needed yet. I hope to never have to. I think the lengthening procedure is going to prevent it.

    -Smish

  8. Good post,This was exactly what I needed to read today! I am sure this has relevance to many of us out there.

  9. Whats up ! Love your blog.

  10. Really this is a latest news for me. Today, you have been taught me a different news for me. Good work. Thanks for sharing…

  11. Two years ago I fully ruptured my Achilles tendon. Within 3 days I had surgery to repair and was put in a cast for 8 weeks post-surgery (my leg was in an immobile, hard cast).

    After removal of the cast, several of internal stitches that were meant to dissolve, had not, and were visibly poking through my skin. After a few weeks, one of them was naturally discharged and a small, blue, knotted stitch “popped out.” (It literally came out of my skin and I was holding the small stitch in my hand)

    One of the stitches was never discharged. It caused discomfort for several more weeks, but I presume that it eventually “dissolved” as it was designed to do.

    However, at the site of that stitch, I now have a skin to tendon adhesion. It is sometimes painful and causes my skin to “pucker up” during plantar flexion of the calf muscle system.

    I went through post-operative physical therapy, which included techniques to break up adhesions. These included Graston technique, massage, ASTYM, Active Release therapy, and self massage (in addition to general strengthening and flexibility exercises).

    The skin to tendon adhesion causes some pain and discomfort and also restricts my range of motion and flexibility. I believe that it is also inhibiting a full recovery of muscle strength in the calf.

    My question: What options do I have to break up skin to tendon adhesion in my Achilles? Any non-traditional, unorthodox techniques that have worked for anybody? I would try anything at this point to get back to 100%.

  12. hi all,great reading here.2 half yrs ago i ruptured my tendons but was missed diagnosed for 4 months as pulled muscle.had op in June 3 cm of a gap so when tendons freed up was left with 2 cm gap so plantaris was used.was left in cast for 10 weeks.was seating down one day when i notice yellow puss coming from cut.went back to surgeon who Treated the infection on 25 Oct was brought back into surgery and it was cleaned up and a stitch removed.he said there was partial healing.2 yrs of me complaing i was sent to orthotics clinic where he said my leg muscle was 5cm smaller,he made a brace to help me walk and finally i was referred to another surgeon who now tells me i am lookin at another op .my foot is clawing and arch is high.has anyone else this problem Ty

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