“Surgery and reopened wound?”
I am a 33-year-old female with 3 children, and we are very active! On May 30th I had to go to the ER for a laceration on the top of my foot. I disclosed from about an inch below my wound to the top of my foot and into my great toe were completely numb. I could not extend my great toe either. I was given x-rays, sewn up, and told there was no tendon or ligament damage. To go about my usual business and keep my wound clean. Stitches out in 10 days. Surprised? I was too! But never having stitches or such a laceration before I said ok. On June 9th I saw a primary care physician to have them removed. She was immediately concerned I could not move my great toe and numbness was still present. My great toe was actually causing me to trip. Removed stitches wound looking pretty good, but still shocked they didn't suspect or investigate the possibility of tendon or ligament damage. She referred me to ortho. On June 10th I had a consultation with ortho, she was disappointed at the outcome of my ER visit. Confirmed with ROM and where the wound was there was no doubt I had tendon laceration. She placed me in a walking boot (only to come off when sleeping) and scheduled me to see the surgeon Monday, June 13.
Before seeing the surgeon on Monday, Saturday night I woke up to use the restroom half-asleep, after 11 days post-injury being placed in a protective device, I didn't put on went to the restroom located in my room, tripped over my nonfunctioning great toe, reopening the wound. So! Surgeon Monday again disappointed in prior care, in addition to the ortho before him not adding crutches to my boot. which he believed attributed to the wound reopening. He agreed the EHL extensor tendon in R foot was lacerated. Now we have several problems. It's already 2 weeks post-injury and my wound is open. But it needs to be corrected, it's hindering my walking and will continue to and we are a very active family and again still young.
So, after some thought, with a very strict plan and my solemn promise, he agreed it would be ideal to repair this and will see me Friday, June 17. He placed me on oral and topical antibiotics, remain in a boot, non-weight bearing, using crutches. Basically, bed rest until surgery and 1-2 weeks after. I said I will do anything to get the best outcome, I am fortunate enough to have retired parents who can be with our children to heal properly and allow my husband to work. Sorry for the short story wanted you to understand the whole picture so you can answer to the best of your knowledge.
I am doing everything he said my open wound looks great am making progress and still healing. Would there be any reason that I would arrive Friday for surgery that he deny the procedure after agreeing to the plan, and following to a t showing progress? What would the likely reason be if he did? Little nervous.
Also any suggestions besides what I am doing to speed up recovery?
Before seeing the surgeon on Monday, Saturday night I woke up to use the restroom half-asleep, after 11 days post-injury being placed in a protective device, I didn't put on went to the restroom located in my room, tripped over my nonfunctioning great toe, reopening the wound. So! Surgeon Monday again disappointed in prior care, in addition to the ortho before him not adding crutches to my boot. which he believed attributed to the wound reopening. He agreed the EHL extensor tendon in R foot was lacerated. Now we have several problems. It's already 2 weeks post-injury and my wound is open. But it needs to be corrected, it's hindering my walking and will continue to and we are a very active family and again still young.
So, after some thought, with a very strict plan and my solemn promise, he agreed it would be ideal to repair this and will see me Friday, June 17. He placed me on oral and topical antibiotics, remain in a boot, non-weight bearing, using crutches. Basically, bed rest until surgery and 1-2 weeks after. I said I will do anything to get the best outcome, I am fortunate enough to have retired parents who can be with our children to heal properly and allow my husband to work. Sorry for the short story wanted you to understand the whole picture so you can answer to the best of your knowledge.
I am doing everything he said my open wound looks great am making progress and still healing. Would there be any reason that I would arrive Friday for surgery that he deny the procedure after agreeing to the plan, and following to a t showing progress? What would the likely reason be if he did? Little nervous.
Also any suggestions besides what I am doing to speed up recovery?
Female | 33 years old
Complaint duration: 16 days
Conditions: R EHL laceration repair
11 Answers
EmergencyMedicineEmergencyPhysician
Thank you for sharing your detailed story. It sounds like you've been through a lot, and it's great to hear that you're making progress with your healing. Let's address your concerns one by one.
Reasons for Potential Surgery Denial
While it's unlikely that your surgeon would deny the procedure after agreeing to the plan and seeing your progress, there are a few potential reasons this could happen:
1. Infection: If there are signs of infection that could complicate the surgery, the surgeon might postpone the procedure to ensure your safety.
2. Wound Condition: If the wound hasn't healed sufficiently or if there's significant swelling, the surgeon might decide to wait until the conditions are more favorable.
3. Medical Clearance: Sometimes, additional medical clearance is needed from other specialists, especially if there are underlying health concerns.
4. Administrative Issues: Occasionally, insurance or administrative issues can cause delays or denials.
Suggestions for Speeding Up Recovery
You're already doing a lot to ensure a good recovery. Here are a few additional tips:
1. Nutrition: Ensure you're eating a balanced diet rich in proteins, vitamins, and minerals to support tissue repair. Foods high in vitamin C, zinc, and omega-3 fatty acids can be particularly beneficial.
2. Hydration: Staying well-hydrated helps your body heal more efficiently.
3. Rest: Continue to rest as much as possible. Avoid putting weight on your foot and follow your surgeon's instructions closely.
4. Physical Therapy: Once your surgeon gives the green light, physical therapy can help you regain strength and mobility in your foot.
5. Wound Care: Keep the wound clean and dry, and follow any additional wound care instructions provided by your healthcare team.
It's understandable to feel nervous, but it sounds like you're doing everything right. Keep communicating with your healthcare providers, and don't hesitate to ask them any questions you have. You're on the right track, and your dedication to following the plan will pay off.
Reasons for Potential Surgery Denial
While it's unlikely that your surgeon would deny the procedure after agreeing to the plan and seeing your progress, there are a few potential reasons this could happen:
1. Infection: If there are signs of infection that could complicate the surgery, the surgeon might postpone the procedure to ensure your safety.
2. Wound Condition: If the wound hasn't healed sufficiently or if there's significant swelling, the surgeon might decide to wait until the conditions are more favorable.
3. Medical Clearance: Sometimes, additional medical clearance is needed from other specialists, especially if there are underlying health concerns.
4. Administrative Issues: Occasionally, insurance or administrative issues can cause delays or denials.
Suggestions for Speeding Up Recovery
You're already doing a lot to ensure a good recovery. Here are a few additional tips:
1. Nutrition: Ensure you're eating a balanced diet rich in proteins, vitamins, and minerals to support tissue repair. Foods high in vitamin C, zinc, and omega-3 fatty acids can be particularly beneficial.
2. Hydration: Staying well-hydrated helps your body heal more efficiently.
3. Rest: Continue to rest as much as possible. Avoid putting weight on your foot and follow your surgeon's instructions closely.
4. Physical Therapy: Once your surgeon gives the green light, physical therapy can help you regain strength and mobility in your foot.
5. Wound Care: Keep the wound clean and dry, and follow any additional wound care instructions provided by your healthcare team.
It's understandable to feel nervous, but it sounds like you're doing everything right. Keep communicating with your healthcare providers, and don't hesitate to ask them any questions you have. You're on the right track, and your dedication to following the plan will pay off.
unfortunately that is something i need to see
Hi! Due to your age I would repair the tendon and have the area flushed out in the or. The best way to heal uneventfully would be to follow your post op instructions and when the time is right physical therapy.
If you are scheduled for surgery tomorrow I would not expect the case to be canceled unless you or the surgeon contracted Covid or if you don’t obtain medical clearance for surgery such as lab work coming back abnormal.
Sorry for the late response as I’ve been out of the country. At this point, I trust your surgery went well. The only 1 reason I could think that your surgery might have been delayed would be an active infection. Focusing on
postoperative recovery, besides doing what your surgeon recommended, increasing your intake of protein & Vitamin D has been shown to shorten healing time. The best of luck to you!
postoperative recovery, besides doing what your surgeon recommended, increasing your intake of protein & Vitamin D has been shown to shorten healing time. The best of luck to you!
Be prepared to use a graft. Even though this appears to be a straightforward repair of tendon damage there is a gap between the ends. That distance is presently unknown, only estimated. Therefore, the tension on the repair is the greatest risk of failure. Autograft or allograft can be used to bridge the gap and improve the outcome. The surgeon should be prepared to integrate the graft if needed.
Good luck.
Good luck.
You are doing fine. There was a series of unfortunate events that delayed your surgery and ultimate recovery. Keep this in mind, you are 33 years old and you will need your foot for another 60 years. Therefore a delay of 2 weeks is not a long time compared to 60 years. Tendons take 8-12 weeks to heal, so you will be in the boot for a while. Wear it whenever your foot hits the floor. No exceptions. Doing that will speed your recovery up. I see no reason the surgery would be delayed on June 17,
Wow, that’s a very traumatic past couple of weeks for you. A few caveats First tendon lacerations need to really be fixed surgically within the first 3 weeks otherwise you tend to get retraction of the healthy tendon and it can be hard to suture them back together and a graft may be needed. Once you heal whether it’s end to end of your own tendon or with a graft your function will be normal just recovery is slower with a graft.
Second in regard to open wounds. I would say it’s more important to fix the tendon and heal the wound later. As long as the wound is clean and not contaminated you can go to the OR. Just go on antibiotics and at least cover the tendon after surgery skin wounds can heal.
I’m sorry you went through this hopefully your tendon can be stitched and you will be back to normal.
Second in regard to open wounds. I would say it’s more important to fix the tendon and heal the wound later. As long as the wound is clean and not contaminated you can go to the OR. Just go on antibiotics and at least cover the tendon after surgery skin wounds can heal.
I’m sorry you went through this hopefully your tendon can be stitched and you will be back to normal.
He will do his best to repair your tendon. He may need to use a graft for strength/augmenting of the tendon repair. You are at higher risk of infection. It was handled poorly, for sure. But a good surgeon should be able to give you a good outcome. Be a good patient. Hope it doesn’t get infected/more infected. Trust what your surgeon tells you and follow instructions.
Difficult situation. I recommend you continue what you are doing and remain non weight bearing on the foot
Ok, wow, what life changing events the last few weeks you have had, some people do not have all these things happen all at the same time in a decade. Well, to answer straight to the point: Surgery is cancel usually if there is any risk of putting the patient in more harm then the benefits of the surgery, so if there is any signs of infection in the area of concern, then surgery likely will be cancelled. As far as speeding up the progress, there is no silver bullet with that, the human body has a time frame on healing with skin tendon ligament etc... Then lastly, I would continue to follow the surgeon's plan, and good luck with recovery.
