Infection and scared

My ortho thought I might have an infection at the bottom of my incision because it was red and a little puffy and there was still a small (2 cm) scab at 11 weeks post-op. He sent me to an infectious disease specialist who also thought it was infected. I’m now halfway through my second course of antibiotics (Keflex and Bacrim) and it may still be infected. Has anyone experienced this? My PT said that the worst case scenario is that they would have to go back in, scrape the infection out, and redo the repair. Has anyone heard of this happening? I am making great progress with my rehab, walking almost without a limp, and am terrified of a set-back at this point.

9 Responses to “Infection and scared”

  1. Hi serlich —

    Your story sounds similar to mine, and your PT’s worst case scenario did just happen to me as late as last Friday.

    I too did have a portion of my wound that did not heal at 11 weeks post op and infection treatment by my ortho needed the additional attention of an ID specialist. I had a rare staph infection that turned into osteomyletis (bone infection). This required an aggressive regimen of a twice daily, two-hour long intravenous drip of vancomycin. I’ve had a PICC line in my arm for the past six weeks and have had a home nurse assigned to me.

    As the bone infection was treated, I also developed pseudomonas aeruginosa and was changed to the cefepime antibiotic, still via IV. I’ve had weekly cultures and blood tests and my share of bone scans and MRIs, and I’m glad to say that both infections have cleared.

    My ortho suspected that have had a reaction to the non-absorbing sutures on my tendon and went in last week for debridement surgery to remove those stitches and to clean up the bad tissue. I am again in a cast and hope to see my wound again next Monday at my 10-day post-op visit.

    My IV treatments have been extended another two weeks to clear out any lingering bugs in me, especially since I have been opened up again.

    Needless to say, my tendon recovery/use has taken a back seat. I’ve been on this journey for the past six months and I hope that you will not have this same experience. The hardest part of having an infection is the tenuousness of it all — how one thing morphs into another — and that infection IS a serious matter.

    There is a lot of hope and encouragement, however. Keep talking to your infection specialist and your ortho. Ideally, have them talking to each other, as mine have done. Keep on your meds and watch for how your body responds to them.

    You can check out my story at Hang in there — your tendon has become stronger — and you’re getting the attention you need.

    ~ booklady

  2. Hi Sehrlich,

    I would definitely make sure that it is an infection and not just scar tissue. In my case, I also had (have) two small lumps (which are dark) on either side of my incision towards the bottom of my incision. The problem I had was that a bit of the suture was still left inadvertantly at this site and was only removed after 10 weeks post-op. I now find (11 weeks post-op) that this lump is slowly reducing in size with deep massage.

  3. Hi sehrlich: I am going through a similar situation as yours and posted a longer reply to you which is probably awaiting your approval on your dashboard under “edit comments”. Hang in there — allowing the antibiotics to take its course is a test of patience. Take care!

  4. Just reading your entry and I think I may be in the same boat as you. I’ve been pain-free since Day 2 of surgery. Now 19 days later, there is pain right along my incision, especially towards the bottom-half. It’s a bit red and puffy.

    However, I also just took out my last insert in my boot and wondering if this could be the reason why it’s puffy and red.

  5. Hello sehrilch, one of my co-worker’s spouses had an ATR about 3 years ago. Things were going okay, until he was at about 12 weeks post-op and went in for a check up and his ortho said let’s keep a cast on for two more weeks, and then again two more weeks. Well come to find out he had a SERIOUS infection where his incision was. He spent a week in the hospital, and was kept in restriction so the infection would not spread. They had to go in and “clean out” the infection, and in the end removed his achilles, because it was now beyond repair. He no longer has an achilles. His ortho specialist said many people function without them.

  6. I happen to be one of those people walking around WITHOUT an achilles tendon. I developed what looked to be a blister about the size of a dime along the incision at about 9 weeks post-op after ATR. The blister had some discharge but apparently it wasn’t enough of a concern for my Physical Therapist to send me back to my Ortho. The blister seemed to improve until about week 12 post-op when the blister re-appeared with a vengeance. It became red around the blister and warm to the touch. I developed a low grade temperature and made an appt. with my Ortho. He sent me into surgery the same day for a debridement or “wash out”. After the procedure he told me that his original repair “looked good” and that the cultures taken from the area would be sent to infectious diseases lab for analysis. I began heavy antibiotics through IV and spent 4 days in the hospital. Lab results returned showing staph infection. Doc sent me home on antibiotics. The day I went home the wound site opened up again in the exact same area of the blister. Doc said that was to be expected and that it needed to heal from the inside out. 2 weeks later I was referred to a different Ortho and he could actually see the tendon hanging out of the back of my incision as well as the fiber stitches used in the original ATR repair. Surgery scheduled for same day for another “wash out”. After surgery I got the real bad news that the tendon was deteriorated to nothing but “GOOP” and “MUSH”. The tendon had to be removed completely. A wound vacuum was inserted into the wound for three days to aid in the closing of the wound as well as help any new infection. While staying in the hospital for 4 more days I continued to take heavy antibiotics through IV. After the 4th day the wound vac was removed and the wound was stitched up again. I am now healing without infection but will have to make a decision in the next three weeks about whether or not to undergo a fifth surgery to do a tendon transfer from my big toe(FHL tendon). The tendon is cut from under the big toe and re-routed through a hole that will be drilled through my heal bone and secured by a screw that goes through the bone as well. The tendon is then sewed up near the calf muscle and acts as the achilles. Wondering if I am the only sorry bastard that this has happened to? I am a 37 year old father of three who was playing volleyball with 10 year old’s when the ATR occurred.

  7. Shinebox: There is a guy at my church that had that experience. He now walks around in tight cowboy boots (Cowboy boots are common where I live) and has a slght limp. He stopped at 5 surgeries and decided to live with whatever he had after that.

    I am so sorry this is happening to you. Hang in there.

  8. Shinebox,

    It is terrible what happened to you.

    I heard of another method: there is some sort of artificial tendon that can be built in.
    It was done for a lady in Montreal.

  9. Shinebox,

    I was wondering if you decided to have the surgery and if so what happened.

    I have a similar situation. I was born with severe clubbed feet and had multiple reconstructive surgeries on both bone and tendon when I was a baby. Last year I tore my achilles tendon while hiking with my sons boyscout troop. I am also 37 with three boys and at that time was the leader of there boy scout troop and cub scout pack. One surgeon told me my tendon was mush and not to have surgery, while another surgeon told me surgery would be no problem and I would be fine. I had the surgery and a year and two months later my leg is still swollen and red and very painful. I went to see a specialist last week who told me that the first surgeon was correct and that my tendon is now tearing somewhere else and needs to be replaced. They want to do an Achilles tendon debridement with an FHL tendon transfer. I have read both good and back things about this. She says that I do not have to have the surgery but eventually it will tear all the way again and I will have no choice. So far online I have not found any posts from people who have had the surgery and we’re happy with the results so I was hoping to find someone who has had it.

    Sorry to hear that your going though this hopefully everything will work out for you.

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