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Seroma or Infection?

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Old 13th September 2010, 12:07 PM
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Default Seroma or Infection?

I stepped on a nasty nail that went in about 1 inch, which did not heal completely after taking antibiotics for two months (kept leaking clear fluid, about one tear drop a day) and developed a lump behind the skin. I went to a foot surgeon, who opened it up, cleaned it out, said he removed the lump mass he said looked like a tumor growth, and a piece of dark material.

After thinking about this, before the surgery, and apparently during the surgery, no culture was taken (no results given to me) and he gave me clyndamycin, 150mg, twice a day, and told me to leave the dressing alone for one week. He looked at it the next week, decided not to remove the stitches, and told me to come in the following week. He then asked me what happened, did I get it wet, at the second visit after the surgery.

I answered no, and then he took a culture (shoving a straw type device with a cotton tip if I can describe it best) up into the wound, making it bleed, etc. He doubled the dose of antibiotics and told me to see him next week. So on the third week after the surgery, he tells me that the culture results came back negative for anything, and stuck another one of those things into the wound to get a culture. He put me on CIPRO and Augmenten told me if it doesn't get better, he will put me in the hospital for treatment with IV antibiotics in case it is pseudomonas.

Puzzling to me is no cultures were taken during surgery, low antibiotic doses after the surgery, and then the two cultures taken after the surgery that have aggravated the wound. After getting the second culture, I could not wiggle my toes due to the swelling, and that night it produced about a hundred tear drops of clear fluid. Now it feels like the muscle beneath the puncture is swollen or getting hard. When I press on it in a certain area, I can make clear fluid ooze from the wound, although it is getting less every day (about ten tear drops) (and I can wiggle my toes again).

I have to see this doctor again this week, and I have been collecting all my gauze from changing the dressings, wondering if some lab could test them for infections. I'm wondering how can I tell if the doctor is causing a seroma condition to occur rather than treat an infection, I want to give this guy the benefit of the doubt, but since he only sees me for a few minutes, and has a lot of patients, I am wondering if my treatment plan suffered errors because he had a lot of work on his hands.

I was tempted to take some body building supplements, but I don't want to feed an infection if that is what it is. The gauze that I remove is pink in the center, then clear, with a green ring around it, although I can't tell if that is from neosporin. What questions should I ask this doctor the next time I see him?
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Old 13th September 2010, 01:05 PM
Trucker Trucker is offline
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Default Re: Seroma or Infection?

I went ahead and registered to this forum so I could make replies, and the original post was posted by me.

I thought I should clarify that the muscle behind the wound, only gets stiff after walking on it (doing house chores, going to the store, not more than ten minutes or so), right now I can press on the wound gently and not feel anything hard. I assume it gets hard from fluid building up in it, and the fluid seems to follow the muscle that run from my heel to my toe, like there is a channel about an inch from the wound.

The nail that did the damage was a black nail that was probably 20 percent gone from rusting in the yard (something from months or even years ago) and penetrated about .75 to no more than one inch).

Only x-rays have been done. No bone damage shown in the X-rays. The wound has almost closed up, I think the leaking fluid is keeping it open, and pressure in the area is relieved when I gently press the fluid out of the wound when it builds up.

I'm thinking of asking about using medical maggots to clean out the wound, but since the wound is almost closed, I don't know if this is a good idea or not, or if I should request that method if the doctor wants to remove more flesh.
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Old 24th September 2010, 07:27 AM
Manuel555 Manuel555 is offline
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Default Re: Seroma or Infection?

Quote:
Originally Posted by Unregistered View Post
I stepped on a nasty nail that went in about 1 inch, which did not heal completely after taking antibiotics for two months (kept leaking clear fluid, about one tear drop a day) and developed a lump behind the skin. I went to a foot surgeon, who opened it up, cleaned it out, said he removed the lump mass he said looked like a tumor growth, and a piece of dark material.

After thinking about this, before the surgery, and apparently during the surgery, no culture was taken (no results given to me) and he gave me clyndamycin, 150mg, twice a day, and told me to leave the dressing alone for one week. He looked at it the next week, decided not to remove the stitches, and told me to come in the following week. He then asked me what happened, did I get it wet, at the second visit after the surgery.

I answered no, and then he took a culture (shoving a straw type device with a cotton tip if I can describe it best) up into the wound, making it bleed, etc. He doubled the dose of antibiotics and told me to see him next week. So on the third week after the surgery, he tells me that the culture results came back negative for anything, and stuck another one of those things into the wound to get a culture. He put me on CIPRO and Augmenten told me if it doesn't get better, he will put me in the hospital for treatment with IV antibiotics in case it is pseudomonas.

Puzzling to me is no cultures were taken during surgery, low antibiotic doses after the surgery, and then the two cultures taken after the surgery that have aggravated the wound. After getting the second culture, I could not wiggle my toes due to the swelling, and that night it produced about a hundred tear drops of clear fluid. Now it feels like the muscle beneath the puncture is swollen or getting hard. When I press on it in a certain area, I can make clear fluid ooze from the wound, although it is getting less every day (about ten tear drops) (and I can wiggle my toes again).

I have to see this doctor again this week, and I have been collecting all my gauze from changing the dressings, wondering if some lab could test them for infections. I'm wondering how can I tell if the doctor is causing a seroma condition to occur rather than treat an infection, I want to give this guy the benefit of the doubt, but since he only sees me for a few minutes, and has a lot of patients, I am wondering if my treatment plan suffered errors because he had a lot of work on his hands.

I was tempted to take some body building supplements, but I don't want to feed an infection if that is what it is. The gauze that I remove is pink in the center, then clear, with a green ring around it, although I can't tell if that is from neosporin. What questions should I ask this doctor the next time I see him?
Seromas are particularly common after mastectomies, abdominal surgeries,and plastic surgery like face lifts. The neck area is usually affected and swells requiring it to be drained. Many patients find that it makes their initial recovery period more difficult, and some need repeated visits to their doctor to have the seroma fluid drained
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Old 24th September 2010, 11:51 AM
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Default Re: Seroma or Infection?

Quote:
Originally Posted by Manuel555 View Post
Seromas are particularly common after mastectomies, abdominal surgeries,and plastic surgery like face lifts. The neck area is usually affected and swells requiring it to be drained. Many patients find that it makes their initial recovery period more difficult, and some need repeated visits to their doctor to have the seroma fluid drained
Seroma
From Wikipedia, the free encyclopedia

Seromas are particularly common after mastectomies, abdominal surgeries,and plastic surgery like face lifts. The neck area is usually affected and swells requiring it to be drained. Many patients find that it makes their initial recovery period more difficult, and some need repeated visits to their doctor to have the seroma fluid drained.

Nice going Manny. As proved above, all of your posts are just selected reprints from Wikipedia. Do you really think you're being helpful or do you just want to see your alias in print?
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