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Abscess. Incision Problems & Osteomyelitis

C-cat
0 Recommendations

Has anyone had problems with a CABG incision not completely healing? I had a CABG4 in October, 2008, and the base of my sternum incision has not closed. I have to pack it twice daily and pus is still coming out. I was diagnosed with osteomyelitis (chronic bone infection) in December. The opening developed an abscess and now I have another abscess about an inch above it. What have others experienced? It is now 9 months since the surgery and I have really bad rib, back and shoulder pain. What's the deal?

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MRSA Surgery Hysterectomy Back pain Diabetes Fever Pain Weakness Osteomyelitis

11 replies

Winglover

Sounds very scary to me! My father had a sternal infection after his bypass as well. They opened up the wound, packed it etc. He ended up having his sternum removed and a muscle flap done. Not trying to scare you.....but pus coming out does not sound good. What does the surgeon say? Have they sent you to a wound care clinic? Are you running a fever? Have they cultured the drainage? Keep bugging the docs until they listen to you before the infection gets further into the bone.

ckgoduto

Did they che3ck to be sure it isn't MRSA?

sternum

Good morning C-cat:

Yes there are others out there you have had osteomyelitis. I developed it after a quad by-pass along with fluid around my lungs. Because the coughing was so intense and the infection so bad, the breast bone was shredded beyond repair and had to be removed. The drs. used a dry packing and irregation system to draw out the infection and a pic line to administer vancomicin interveinously. It took a while but the infection did clear up. (that's weeks not months). Check with your dr. to see what type of antibotics he is giving you. As winglover said puss running out is not a good thing. And make sure dr. does his research on openpacking and irrigition. It has only been in use for about five years but it is having amazing results.
Feel free to ask any questions. I would be happy to help you with anything I can.

Take care and be blessed --- Gloria ---

By the way, when the breast bone cannot support the rib cage, the job is left to the spine to take up the slack. And yes it will give you a back ache. That is when it is important to keep your shoulders up and your back straight. The rib cage has a natural tendancy to curve toward the center without support if you don't.

C-cat

Well, here it is 10 1/2 months since original CABGx4. Still have rib, shoulder & back pain. And still have two open sores on my incision line. Still packing it lightly, still has some clear liquid and yellowy-beige liquid that drains onto the gauze. Still very raw and burney feeling. It is not MRSA, thank goodness. About 3 weeks ago, we decided to NOT revise the incision and give it more time to close on its own and there is concern that I would still have trouble with a new incision closing due to Diabetes. The doctor says my sternum is stable and has pushed on it very hard to verify along with CT. I'm just tired of not being 100% better. But I know I am much healthier than before the surgery and I look better, too.

C-cat

Another month has gone by and still not healed. The granulating tissue keeps degenerating. So this morning, the PA cut out the bad stuff (ouch). Now it looks like I'll be having a vac placed in the hole. Any info would be helpful.

sternum

Hi Ccat:

I'm glad you are still keeping us informed.
After my sternum was removed the very first thing decided was that the tissue was still too infected for a muscle flap and the vac therapy was done immediatly. Victoria's Royal Jubilee Hospital did a report stating the vac system of dealing with the infection made the healing process time much quicker and less open to more infection. The vacs are small and portable now and just sit on the shelf of a walker. They are electric powered and also can be run for about an hour on battery. The packing itself is a very dense black foam saturated with an antibiotic. The packing is cut to fit the wound completely and has a round button shaped valve in the center. All of this is sealed with a clear film. ( Make sure to tell the nurse who does it to keep the film well away from your nipples. I had it happen once and I don't want to remember how painful it was when that particular piece of film was removed. But it never happened again.) OK -- So once that seal is made a small hose is attached to the valve and the other end is hooked to the vac itself. Once all the settings are entered the vac is turned on. You have a slight tugging sensation as the vac starts and removes the air under the film, much the same way a food saver works. This packing is changed every other day until the the discharge is a fairly clear fluid.

Honestly the difference between what you have alread been through and the vac treatment is amazing. This system takes a few weeks (for me--between 3 1/2 & 4 )as compared to the almost 11months you have already had to endure. I'm just sorry for you that this treatment wasn't done immediately.

All the best to you and again keep us posted on your progress.

Be Blest --- Gloria ---

C-cat

Thanks for your information - it is reassuring to know. I've read some web info and the vac definitely gets positive results. My opening is not even the size of a dime, but a q-tip goes in about 1 1/4 inches. It already has good blood flow, but still has drainage (clear to beige). I've been back to work since April and now I'll have to take some more time off, if insurance approves procedure and home nursing. I'm hoping it will only take 2-3 weeks to completely heal. I hate to be homebound again, like an appliance plugged in to a wall.

C-cat

Update: Had the wound vac for ten days, of which half the time was wasted because the machine did not work after two days. The freshly cut tissue perked up, but with the drainage kept collecting under the film and irritated the skin. They didn't use the foam because the wound is small, just used the plastic tube in gauze. Anyway, the granulating tissue started growing out of the hold again. So 2 weeks later, the doctor says to just watch the wound and see if my "excess" tissue will heal on its own--it is still sticking out of the hole and a light yellow to clear drainage still occurs. The tissue is sensitive to the touch and can bleed. I am sooooooo frustrated. My ribs hurt terribly. Saw my cardiologist and even he is frustrated--wants to know what they are going to do. Although, he scared my about the revision and using stomach muscle to rebuild sternum--says it is a tough surgery and is worried I won't heal because of diabetes. He said to get a second opinion from the head of cardio-thoracic. I go next week again--on the one-year anniversary of my CABGx4. BTW, the osteomyelitis is chronic, not running any fever. I'm at the end of my rope and getting depressed. I just want to be free of the pain and having a hole in my chest that stings. Please share with me any of your experiences with this type of thing. (Sternum--If you respond, I would like all the gory details. Thanks)

shelleylynn

I had an issue like this only it was inside after I had a hysterectomy. Everyone looked inside my vagina and said it was healed....try to get on with my life (sex)
and the incision on the inside of my body but would rip open. Happened 3 times with 3 consecutive surgeries to repair and a trip to the Mayo clinic to find out why it would not heal....(no one else could figure it out.) Turns out I had a staph infection, 9 days in the hospital with IV antibiotics....During this entire 9 months I had a low grade fever. Make sure they are treating the right Bacteria. Not all infections are the same. Start getting angry.....Someone will find out how to heal you if you start really putting up a stink, and you have every right to! This is way too long to be infected, especially with an open wound. Those Doctors should be ashamed of themselves.
Good Luck to you, Shelleylynn

C-cat

It is over a year since my original CABGx4. The incision site still leaks at the base and "proud flesh" keeps filling it, but not healing it. I just saw the plastic surgeon. They want to reopen the incision and see what is causing this. It could be: wires, stitches, infection, ziphoid cartilage, tissue, bone. They won't know until they go in again. Best case: a wire and a little cleaning and antibiotics and stitch closed. Worst case: pectoral (or omentom) muscle flap placed over the ruined sternum resulting in weakness and numbness from tummy to shoulders the rest of my life. I've seen pictures on the net, and they are barbaric. Plus, what if I still don't heal and I'll be out of commission for 6-8 weeks (out of sick time). I finally can take in a movie or shop, the holidays are here and I'll be homebound and in a painful recovery. I am terrified and depressed. Anybody been through this?

Winglover

Hang in there my fellow Michigan Heart Sister!

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