Suggest Treatment For Surgical Site Infection

Posted on Fri, 10 Jun 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 10 Jun 2016 Answered on

Thu, 7 Jul 2016 Last reviewed on

Question : I think I am having a reaction to my stitches. Started 4 weeks post-op. I am now almost in my 6th week. I saw my surgeon on Tuesday - she did not know what it was. She called them cysts. Froze them - and lanced them. When I now read about it online - I am having all the symptoms others mention. Sounds mostly like I have to wait it out. I have had Asthma all my life - and contracted ABPA in 2010. I have strong allergic reactions. And always seem to get 'rare' things that it takes the Doctors a long time to figure out.... sometimes they don't. I have to be on a limited diet to control.... that helps. What are your suggestions? Thank you so much. - XXXX

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Can you send me the picture of your stitch line?

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
In my opinion, you are mostly having surgical site infection (SSI) not surgical site allergy.
But it would be of great help to determine allergy if you can send me images of your stitch line.
Also let me know
1. Are they itching?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (3 hours later)

I don't want or think I could send you pics.... they are on my perineum. They were itchy - with a rash on my bum - but they are not itchy since lancing. Lanced twice.
I hope that helps somewhat.
What makes me also think of the allergic route - is that the pain from the interior stitches have increased - and other areas at the site feel swollen and raw. And my asthma has increased this past week - but not for the first month. I do understand surgery is stressful on the body - and asthma.
Thank you for your answer so far - appreciated.
I am thinking I should inform my surgeon tomorrow. I would like to know what you thought of this. And if there is anything 'they' can do for me.
XXXX

Answered by Dr. Drkaushal85 (17 minutes later)

Brief Answer:
Possibility of surgical site infection is more.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
By your history and description, possibility of surgically site infection is more.
Allergy is somewhat which comes immediately if you are allergic to that stitches.
Lag period of 4-6 weeks is characteristic of surgical site infection.
Pain, redness, swelling, cysts like things etc are more suggestive of infection rather than allergy.
Clinical examination of surgical site is the best thing to determine this.. So better to consult your surgeon and discuss all these.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (1 hour later)

Thank you Dr. Bhavsar.
That gives me direction.
Two last questions.

I notice on the Net - others talk about being diagnosed with SSA (allergy) - 4 weeks post op, and that it did not start before. I hear you when you say allergy comes immediately though. Is there a possibility that reaction could be delayed to this?

Your description of SSI does match except not much redness though.

And my increased breathing problems - what do you think attributes to that?

Thank you again. - XXXX

Answered by Dr. Drkaushal85 (9 minutes later)

Brief Answer:
Delayed type of allergy can be seen.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, I agree that some allergy can be seen after some weeks. It is known as delayed type of allergic reaction.
But these reactions are usually mild and not causing pain and swelling.
So my assumption is still SSI.
May I ask few more details about your asthma and surgery?
Please let me know
1. Which suture material was used?
2. Which inhaler or treatment are you taking for asthma?
3. Have you ever experienced fever or raised body temperature after surgery?
Infection can also worsen underlying asthma.
So please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar