“External iliac artery exploration?”
My mother underwent a bilateral external iliac artery exploration and the surgeon nicked a lymph node. She got immediately infected in both incision sites. They did a washout on the right side which is the longest incision. It is 16 cm long and still has stitches in it. My question is what is the best treatment to enable these wounds to heal as it has been 5 weeks since the surgery. They have been giving Vancomycin and Zicor (sp) most of the time. They put on a wound vac and she went to a post-acute center and they removed it.
Female | 77 years old
5 Answers
VascularSurgeon|VascularSurgeryVascularSurgeon
Sounds like they are doing the right things with wound care, wound vac, antibiotics, and post-acute nursing care. Optimizing any other medical problems that she might have is also important to promote healing along with balanced nutrition.
Just to clarify, "nicking the lymph node" may not have anything to do with her delayed wound healing or infection. Lymph nodes are all over our bodies and especially along blood vessels and in the groins. It is impossible not to move, excise, or dissect lymph nodes when operating on the external iliac artery. That is expected with any open vascular surgery.
Just to clarify, "nicking the lymph node" may not have anything to do with her delayed wound healing or infection. Lymph nodes are all over our bodies and especially along blood vessels and in the groins. It is impossible not to move, excise, or dissect lymph nodes when operating on the external iliac artery. That is expected with any open vascular surgery.
Re-explore the wound. Don’t use cautery, use absorbable sutures like monocryl on lymphatics channels and bleeders apply topical hemostatics(biologic). Leave wound open with daily wound care. Hyperbaric oxygen therapy daily. No wet to dry dressings. Appropriate antibiotic therapy, culture, and sensitivity test based including fungus. Secondary wound closure when appropriate. Personal hygiene cannot be overemphasized.
Good evening,
Dr. Fields recommended that you contact the Wound Center here at Washington University. The number to the wound center is 314-362-1300, they will be open again at 8am on Monday morning.
Dr. Fields recommended that you contact the Wound Center here at Washington University. The number to the wound center is 314-362-1300, they will be open again at 8am on Monday morning.
Please consult Functional Medicine. Thyroid must be optimized, hemoglobin level should be above 13. Vitamin B12, Vitamin D levels must be above 75th percentile. Vitamin C daily for collagen repair.
A wound vac would probably be the best option
