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Thyroid (Expert Forum)
Multiple Stitch Abscesses along Thyroid Incision Line ... Surgeon never saw this before ? ? ?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Dr. Mark Lupo. Topics covered include goiter, graves disease, Hashimoto's thyroiditis, hyperthyroid, hypothyroid, thyroid cancers, thyroiditis, and thyroid stimulating hormone (TSH).
Multiple Stitch Abscesses along Thyroid Incision Line ... Surgeon never saw this before ? ? ?
by ChitChatNIne, Feb 28, 2007 12:00AM
Multiple Stitch Abscesses started 4 weeks post op partial thyroidectomy!! (See links below to photos).
My surgeon who has done over 900 thyroid surgeries said he has never seen a reaction like this before. One of them became boil-like and ruptured on 2/24 and feels better. At first I was put on Keflex 500mg 4X/day but now off the antibiotic and doing hot soaks 3-4X/day.
My surgeon will give this 3 weeks to a) resolve b)get worse or c) stay the same. He wants to go back into the incision and clean it out in the OR and/or do a TT bcz of the microcarinomas found on the removed lobe.
What are your thoughts? Ever had this happen with any of your surgeries? Are multiple points like this really that uncommon?
I am going to see my Primary Dr. today to get his opinion and seek another opinion from another surgeon.
Could this be allergic reaction or do you think contamination ? Never had reaction like this to any surgeries.
Geez, I may never know the answer but I had the surgery on 1/9 and had 2 weeks of nice healing not even knowing I had a scar and then this started out of the blue 4 weeks post op.
He also said the scar "WAS" healing nicely and whatever the outcome will need scar revision . Is he referring to a dermatologist and cosmetic work I assume?
Before it ruptured:
http://img.photobucket.com/albums/v93/ChitChat9/thyroid/Feb17ThyroidScarOuch.jpg
After it ruptured:
http://img.photobucket.com/albums/v93/ChitChat9/thyroid/Feb24Closeup.jpg
THANK YOU SO MUCH, Cheryl
My surgeon who has done over 900 thyroid surgeries said he has never seen a reaction like this before. One of them became boil-like and ruptured on 2/24 and feels better. At first I was put on Keflex 500mg 4X/day but now off the antibiotic and doing hot soaks 3-4X/day.
My surgeon will give this 3 weeks to a) resolve b)get worse or c) stay the same. He wants to go back into the incision and clean it out in the OR and/or do a TT bcz of the microcarinomas found on the removed lobe.
What are your thoughts? Ever had this happen with any of your surgeries? Are multiple points like this really that uncommon?
I am going to see my Primary Dr. today to get his opinion and seek another opinion from another surgeon.
Could this be allergic reaction or do you think contamination ? Never had reaction like this to any surgeries.
Geez, I may never know the answer but I had the surgery on 1/9 and had 2 weeks of nice healing not even knowing I had a scar and then this started out of the blue 4 weeks post op.
He also said the scar "WAS" healing nicely and whatever the outcome will need scar revision . Is he referring to a dermatologist and cosmetic work I assume?
Before it ruptured:
http://img.photobucket.com/albums/v93/ChitChat9/thyroid/Feb17ThyroidScarOuch.jpg
After it ruptured:
http://img.photobucket.com/albums/v93/ChitChat9/thyroid/Feb24Closeup.jpg
THANK YOU SO MUCH, Cheryl
Doctor's Answer
by Mark Lupo, M.D., Feb 28, 2007 12:00AM
, Feb 28, 2007 12:00AM
Wound care:
Adding Epsom salts (magnesium sulphate) to the hot water for your soaks will help draw out and fight infection. Use a clean washcloth or gauze each time.
After the soaks, use gauze, NEVER COTTON BALLS OR ANYTHING WITH LOOSE FIBRES, with 3-5% hydrogen peroxide to gently wipe off any debris. If you need to, you can wrap the end of a Qtip in gauze, dipped in the hydrogen peroxide to remove stubborn debris.
Loose fibres tend to increase the incidence of wound infection.
Use a triple antibiotic cream to cover wound areas and cover if possible to avoid contamination.
OR
Only if someone else can do this for you - you need to be lying down to avoid inhaling the solvent until the coating is dry. New Skin is a liquid bandage that has excellent antibiotic properties, is waterproof, holds well in difficult to bandage places, and creates a barrier to bacteria, while killing the bacteria under the film. It has an added benefit in that it prevents scab formation and minimizes scarring.
If you have someone who can apply this for you, the next day's application of New Skin is applied directly over the first coat. It is transparent, so you can see how it is drawing the infected material out. I normally leave it on, applying successive coats until the outer edges start to peel and then carefully remove it. It doesn't matter if there is a bit of blood on the skin after removal. Clean off any debris as above, make sure skin is dry and re-apply a coat of New Skin.
Once the skin has closed, you can use a sterilized pin to make a tiny hole in Vitamin E 400IU capsules and gently work the squeezed out oil directly from the capsule onto the new tissue. It helps promote healing.
While taking antibiotics:
To protect the healthy bacteria in your gut that help digest food, you should be taking the probiotics such as Lactobacillus/Acidophilus at each meal during the treatment time for the antibiotics and for at least 2 weeks after. Don't buy this off the shelf - get the refrigerated live culture capsules from a health food store and keep them in your refrigerator.
There is no conflict with your antibiotics to use this.
Don't do the following if you are allergic to sulpha drugs unless your doctor O.K.'s it first:
Another thing that doesn't conflict with antibiotics is taking a gram or 2 of MSM daily. The sulphur in it helps to fight infection from the inside. Expect that any damaged tissue will turn bright yellow, lightening as the tissues heal. It will also light up any hidden bruising on any part of your body.
Damaged tissue needs extra Vitamins C, E and the B-complex group to help heal it quickly.
IF YOU SEE THE SLIGHTEST RED STREAKING developing from any wound, go to your nearest emergency department immediately. It means the infection has entered some local blood vessels and can spread throughout the bloodstream. The only way to deliver antibiotics quickly enough to the bloodstream is by intravenous injection.
Good luck,
sharali
Regards,
Cheryl
I like your suggestions very much .. will use gloves and other ideas .. all but the Liquid Skin I feel comfortable with unless ok'd by the surgeon. So thanks again!
C~
LINK (graphic):
http://img.photobucket.com/albums/v93/ChitChat9/thyroid/Mar507.jpg
C~
C~