Hoping everyone is doing as well as can be in these challenging times.
Some of you will know that I had an ankle replacement five weeks ago. Initially, this was doing really well and at first post of visit in hospital at 3.5 weeks, the surgeon was pleased and discharged me.
However, when the practice nurse removed the stitches, some were tight and cause quite a bit of bleeding, which formed a scab. This now seems to be inflamed and is weepy. I also noticed the other day she had left a stitch in and the scab had formed over most of it.
Really anxious about getting an infection. Called the district nurse who, due to it being the Easter weekend, cannot get to me until Wednesday next week.
I’m worried about leaving it this long. Any suggestions as to the best thing to do? X
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Eiram50
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Aw Marie, what a shame! First word that came to mind when reading your post was Ouch!
I think I would just lightly bathe it with lukewarm water. Keep it super clean. Try to keep clothing away from rubbing it.
If it gets more red and infected looking and painful then NHS phoneline or A&E for antibiotics. Wednesday seems a long time away! Its Easter I know but still.
If you have an n95 mask I would suggest going to the er at about 5am sunday morning. It's the least crowded time statistically and they might get you right in and out.
Sorry to hear that Marie, I recently had a small lump removed from my thigh just above my knee, like you was doing really well, but I believe a stitch was left in and it started to weep and bleed. Was before all the GP’s closed their doors. I was given fucidic acid cream to apply every day and it cleared it up in a week. I know you wouldn’t normally have this in, but do you have any iodine strips to put over. Sometimes they give you dressings when you’ve had stitches. I would keep it dry and covered and if needed just change the dressing. Other than that if you have any emergency chemists open, ring for their advice. Good luck Marie it can be very worrying. X
I had no dressings on and the scab was extremely dry and they told me to wear a sock, to offer some cushioning from the boot. When taking off the sock on Friday, it lifted a bit of the scab off. It was read and wet.
I poured some cool boiled water over it to clean it, patted it dry and put a dressing over it.
There is some fluid/ blood showing through on the dressing.
I’m reluctant to change it before seeing the district nurse on Wednesday, in case I once more, lift the scab off?
My worry is if leaving it, is it becoming infected?
Probably worrying over nothing and my anxiety is probably heightened due to the current situation?
I know exactly how you feel, I was panicking as I was waiting for my back op and knew they wouldn’t go ahead if infected. I would be inclined now to leave it dressed, if you aren’t sure you would not pull the scab off. When I first had the procedure done, I was given dressing to change if the blood came through, I changed it once, an wished I hadn’t as it disturbed one end of it, I was to keep it dry till the stitches came out. It was a good three weeks after the stitches came out, I had the problem and still had to wait 4 days to see a nurse, I did actually see a doctor though, and he prescribed the cream. Iv had an infected mole, that had rubbed on clothing the last week and I used this cream and again it’s worked. I wouldn’t want to go to the surgery now. All the best Marie. X
If fluid had an exit from the wound then it can also add as an entrance for bugs.
2. Ideally I would see if you have a local minor injuries unit close to you?
3.District nurses still practice at weekends as some members of the community still need daily dressings or medications. Is there no information via your GP website. Some teams at weekends are called rapid response teams.
4. If you call 111 they SHOULD be able to give you all the details for non-urgent care. If they don't then push them for it.
5. The NHS is still open for business according to all the daily updates so if necessary go to A&E. I'm not sure of your meds but if you were to get an infection that tracked back into the replacement itself then that would be a real worry.
6. Don't worry about the dressing getting stuck to your wound. It can easily be removed with a good sterile saline soak in an appropriate clinical area.
I'm surprised that an incisional wound hasn't healed after 5 weeks so I am guessing that you might be on some strong meds? If your instincts tell you that something isn't right them I wouldn't leave it to develop further. That is what I would do anyway and I can only share my thoughts and experiences with you.
I do know that A&E departments are seeing 29% less attendances at present. Also, in my local A&E they are directing all patients presenting with respiratory problems to another wing of the hospital in order to keep A&E "clean." I know of another hospital doing this too. That doesn't take the risk away but it does lessen it.
District nurse is still working but due to it being the Easter weekend, it’s a reduced service and only emergencies will be seen.
There is a minor injuries - A and E not too far from me but i would be very reluctant to be in a hospital environment at the minute and wouldn’t wish to be taking up time
Just what you don’t need now or any other time, Marie.
If I had a scalpel (used to have one) I’d want to carefully remove the stitch myself... I have removed my own stitches before when it was obvious they were tightening, causing redness in the skin, and the appt for removal was several days later.
But with an ankle replacement... more care should have been taken to ensure all stitches were removed, especially in a person with RA whose immune system might be a bit dodgy if infection occurs.
They will probably have a very quiet weekend at A&E or minor injury clinics.. it seems that the sooner that wound is properly attended to, the better.
The stitches have been a bit of a nightmare in so far as I stupidly went to the wrong hospital, the day they were to be removed which effectively meant they were about a week late in coming out. That may be why they were so tight then?
I don’t have any increased pain and it doesn’t feel very hot so I will try to hold out for the nurse but should this change, I think I’d have to go to the out of hours clinic / A and E. Really hope not though 😔
I only removed mine as I had done it when nursing. I sterilised my tweezers and scissors first. Not recommended but I knew the signs of stitches needing removed.. and that it is not good to leave them much longer.
Yep, I was going to say the same thing. Probably worth giving your GP a ring. It’s a genuine concern and I’m sure they’d rather hear from you now than leave it to get worse. Are you back on any RA meds? Worried about your ability to fight infection! Take care Marie xx
If it shows any signs of getting worse, I will make sure I see someone ASAP. I won’t take unnecessary risks.
I was due to go back in my RA meds last week but wasn’t sure due to the large scab over my ankle. I was thinking if I went back in them then this would not be good if indeed there was any infection?
How are you feeling Sophie? I hope that things are beginning to feel a little better for you x
I think you’re right about the meds, not worth the risk in case there is an infection. Glad you’re not going to take any risks. Please take care of yourself lovely self. I am slowly improving, thank you xx
That doesn't sound good and wondered as it is an open wound so to speak is the district nurse not able to come out over the Easter weekend as surely those who have open wounds ulcers which need treating would have to have dressings changed etc? Be careful if it is weeping that it doesn't stick to the dressing. I understand the need to keep it covered but as you say if it begins to feel hot or you begin to feel feverish or unwell get straight on the phone. Take care and I hope that it is soon sorted out for you. x
They said they were only responding to emergencies over the Easter weekend and felt that as if said it wasn’t hot to touch etc, they seemed to feel it would be ok until tues/ wed, when they would come out. She didn’t seem concerned about the stitch that had been left in either?
I think it probably will have stuck to the dressing, which is why i don’t want to change the dressing as don’t want to risk ripping it off and further irritating it.
Call your GP tomorrow or call 111 - they keep telling us that all other medical issues will be dealt with
You poor love.What came to mind is an old method, plus harmless.It can also soothe. The best if you have nothing to apply on it. First wash hands thoroughly. I would suggest you bathe it gently with warm boiled water in a small bowl with 1 teaspoon of salt, use a cotton ball, but don’t touch the area, just let the water trickle down onto it(with the bowl under to catch the drips)for 5mins.Then apply a bandage and some Vaseline, or what is available to prevent sticking.At least until you have it looked at.
Also you can apply this each day, it does no harm, prevents infection.
As a retired Emergency Dept nurse I would not remove that dressing unless done so by a saline soak and in a sterile environment.
The first clot /scab is the best clot/scab. The second one is the second best. It needs professional attention. Especially if you have RA. You do not want to develop osteomyelitis.
It had scabbed and my sock took part of it off and it looked red as wet underneath. I poured cool boiled water over it, patted dry and applied a sterile dressing. There is some bold/ fluid that had come through the dressing but not excessive amounts.
I won’t want to take the dressing off in case I once more, rip off part of the scab.
I did notice the practice nurse who removed the stitches had left at least one stitch in!
Whilst it is a bit nippy, it is not what I’d describe as painful and not is it bright red or hot.
If it changes, I’ll seek further medical advise but other than this, I think I’m probably better waiting for the nurse to come and she can remove the dressing etc.
I would call 111. Also if you do go to a hospital they are all separating patients suspected to have Covid 19 from everyone else. I know this to be true because I have been to A&E twice in the last 5 weeks. I would not leave your ankle. You know your body. Please call someone. Good luck.
Thanks pippin. I have spoken to the district nurse and took her advice. But, it does feel a bit of a wait until she can get to me. I’d it changes/ feels worse, I will seek further medical advice . Thank you x
Sorry to hear about this but I think some great suggestions from everyone. As you say it’s not warm so that’s a good thing.
I had a very slow healing wound from my recent mastectomy surgery and long delays in getting the stitches removed. I did my best to be scrupulously clean - hands and wound area. I used cooled boiled water with a little salt or Hibiscrub in it and used cotton wool to drip the water over the wound area then applied iodine strips (Inadine), gauze and bandage. You might be able to get iodine strips from a pharmacy. I got mine from Amazon.
Because of COVID, the clinic cancelled appointments to get my stitches removed and they stayed in for nearly 3 weeks. Not ideal but I managed to keep it all super clean so it has worked out ok so far.
I would try the GP practice first thing Tuesday to see if you can get a same day appointment with a practice nurse or if your district nurse can come sooner. It’s worth stressing that you have RA so have an increased infection risk.
I have found that I take longer to heal in general from cuts, bruises, surgery etc and I’ve put this down to RA but i don’t know if there is any science behind that.
Cleaned it with cool boiled water and then out dressing on as directed. I don’t want to take it off as I can see blood/ fluid in the dressing and dont want to run the risk of tearing off the scab again. Unless it gets worse, I’ll wait until the district nurse comes next week x
Please keep that scab. Many of these solutions like hibiscrub kill bad bacteria but also kill some of the natural flora on your skin too. You need the appropriate environment to heal the wound so keep.the dressing on unless it gets really bad. But keep.in contact with the DNs.
a sign of infection would be a high temperature too so maybe check that. if the dressing has to come off again you could soak it first to get it off. a salt solution in boiled cooled water will keep it clean but will nip. just dont touch it with anything accept a dry dressing or cotton wool xx hope this helps
I’d lightly bathe the area with boiled warm water in a pint basin with 2 teaspoons of salt dissolved in it. Pat dry gently with a clean soft cloth or towel,and then I’d smother with Savlon cream which in antiseptic. Then I’d cover with a soft dry dressing firmly attached with tape. I’d keep all clothing away so as not to disturb the wound. Perhaps tie a soft pillow case round the foot to go to bed. Don’t change the dressing unless the wound starts seeping through the dressing. If that happens start again as above. You can get surgical dressings delivered the next day on EBay. Good luck.
Just to say that I had an ankle replacement about 3 years ago and it is the best thing since sliced bread!! I can walk really well on it and no pain.
With regard to your infection, have you considered visiting one of the minor injuries units at a smaller hospital? I know that in our area, they are dealing with the day to day matters and keeping them away from the main hospitals. NHS 111 would be best to assess whether this is a viable option for you and how important or whether to wait for Wednesday. Best wishes
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