Infected hardware

[jackieg412]

I really would have thought I would be past the time that infection would happen but it doesn't appear to be that way. The wound has been treated since September and started out not looking like too much. Little did I know that the red area that just opened and leaked was an underlying infection. What I thought was minor isn't turning out that way.
The thoracic hardware has been in place since February of 2011. Thought I was good to go but there seems to be another plan.I am on antibiotics now and hardware scheduled for removal on Jan.21.
MAybe last year's car accident had something to do with this.
Any one else know what could cause this infection after this time ?

[LindaRacine]

I really would have thought I would be past the time that infection would happen but it doesn't appear to be that way. The wound has been treated since September and started out not looking like too much. Little did I know that the red area that just opened and leaked was an underlying infection. What I thought was minor isn't turning out that way.
The thoracic hardware has been in place since February of 2011. Thought I was good to go but there seems to be another plan.I am on antibiotics now and hardware scheduled for removal on Jan.21.
MAybe last year's car accident had something to do with this.
Any one else know what could cause this infection after this time ?

Sorry to hear about this. Hope they manage to get it all under control quickly.

Unfortunately, late onset infection isn't all that uncommon. The infection can sort of lie dormant, under the implants, and show up even years later. I don't know about other surgeons, but Dr. Berven typically collects a tissue sample for biopsy when he does most revision surgeries. Non-symptomatic infections aren't unheard of.

--Linda

[titaniumed]

Yes, this article explains that trauma exceeds 10%

Bacteria forms as biofilms on our hardware. These biofilms will go through changes over time....Its something I always wondered about because on some revision surgeries, the hardware does not retain its metallic shine, the rods turn a dull charcoal color.....

(I do not know how other biomaterials react, for example PEEK or UHMW or PET tethers....)

https://journals.lww.com/spinejourna...ofilms_.7.aspx

Jackie, You must feel terrible, go to the hospital if need be.

You have been through so much. I am so sorry

Ed

[Tina_R]

I just saw my elbow surgeon for a followup and he remarked that all surgical infections make their way out to the surface. I bet an elbow surgeon doesn't experience many long-dormant infections such as can happen with fusion hardware, though.

I'm glad it won't be too much longer before you have your hardware removed, Jackieg412, and I wish you the best. If anything new develops, get it looked at or phone your doctor's office.

[jackieg412]

Thanks Tina and Ed and Linda. It has been a rough time since the car accident. The sheer trauma could have done anything. It may have looked okay on X-Ray but you never know. Also the misstep and twist could have injured something. Under the wound is a nerve that activates when the dressing is changed. So medication and antibiotics are being used . The neurosurgeon at Rush ( the one who did both of my broken neck surgeries and saved my ability to funcgion) is aware of the staph infection and is planning on the hardware removal any way. He said the infection won't cure until the source is removed.
In addition I have reacted to the dressing. Has anyone else reacted to tegaderm?. I will have to inform the surgeon as it is a common dressing.

[LindaRacine]

Thanks Tina and Ed and Linda. It has been a rough time since the car accident. The sheer trauma could have done anything. It may have looked okay on X-Ray but you never know. Also the misstep and twist could have injured something. Under the wound is a nerve that activates when the dressing is changed. So medication and antibiotics are being used . The neurosurgeon at Rush ( the one who did both of my broken neck surgeries and saved my ability to funcgion) is aware of the staph infection and is planning on the hardware removal any way. He said the infection won't cure until the source is removed.
In addition I have reacted to the dressing. Has anyone else reacted to tegaderm?. I will have to inform the surgeon as it is a common dressing.

Hi Jackie...

I react to almost anything adhesive that stays on my skin for more than about 12 hours. Strangely Tegaderm is one of the adhesives that causes less reaction in my case.

I'm surprised to hear your cervical surgeon say that he can't cure the infection without implant removal. While that's true for some patients, it's definitely not everyone. It may be that he just said it to assure you about the implant removal, which could be necessary regardless of the infection.

https://www.ncbi.nlm.nih.gov/pubmed/28913559

--Linda

[Tina_R]

It's sobering to see those loose screws and rods in your x-ray after your accident. As I was chauffeured home from the hospital after surgery I couldn't help but think how terrible it might be to get into a car accident in such a fragile state and with embedded hardware.

Whatever adhesive they used around my IV sites irritated me. It might have been Tegaderm if that is the latest thing. Even after the redness was gone it left zit-like sores on my neck that took weeks to go away.

[jackieg412]

Yes that early stage requires more concern. The accident t was very violent. My car was forced into a Rick house.It is amazing to have lived through it. It is also amazing the neurosurgeon was able to make this as good as it is. I am still compromised in my right hand.
I will have to address this tegaderm issue with the staff that will care for me after the hardware removal.. If will not be good to have that rash all over the new incision.

[jackieg412]

The removal surgery was the answer to the non healing wound. In 2 weeks it healed after the hardware was out. I was released yesterday from the neurosurgeon. They described it as an internal pressure wound.
Now we can see if I can move forward with the shoulder surgery.I believe Susan had her shoulder surgery yesterday.
My arachnoiditis has flared. The internal pump may also be having a problem. What next!

[titaniumed]

The removal surgery was the answer to the non healing wound. In 2 weeks it healed after the hardware was out. I was released yesterday from the neurosurgeon. They described it as an internal pressure wound.

This is good news Jackie.....

Just a hunch but I would imagine that they will want some time to go by before you go in again on another surgery. Let things settle down some.

I would talk to your doctors about the Staph, if that's what it was, and how to address this in the future. An antibiotic discussion. You can feel these things, infection is never something to wait on. Should you keep certain antibiotics at home on standby?

I do have my mouth under control now. Been going mental on the dental if you know what I mean....3X per day with listerine flossing and cleaning attacks. Trying to keep my mouth and my hands extra clean these days.....I keep Amoxicillan here at the house these days.

You know on the coronavirus, over the age of 60 they don't want us partying like rock stars. In other words, safer to stay at home, and avoiding social functions. I think if I wanted to get sick, I would go to an elementary school, or take a cruise. My hospital does not want anyone under age 18 coming down to the hospital, unless they are sick. There is a reason for this.

I hope Susan is ok. I worry about her ambulatory or mobility challenges...Of course they will probably get her a Hoyer lift to deal with this for now. These items can be rented.

How is the pain from the rod removal? I would imagine that the arachnoditis overrides this pain....or is it sporadic?

Ed

[RitaR]

How did they determine hardware was infected?

[jackieg412]

I was in a major car accident. After that a wound developed on my back, not right on the incision but next to it. The wound would not heal even with wound care taking over the treatment. After the hardware removal, the wound healed in 2 weeks.

[jackieg412]

You are right Ed, with that virus on the attack we all need extra precautions. I have young grandchildren and I always talk to the parents before I go there. It happened about 2 weeks ago , I put one of them on the school bus, next day she texted positive for influenza A. I didn't get it but stayed away from compromised people for the 7 days. Just in case I didn't want to spread it.
The hardware removal was easy,but recently I picked up something heavy and now the muscles in the thoracic are really sore. I mean keep you awake sore. I was at pain management yesterday and I have a steroid pack. They didn't want to do any trigger point injection because of the recent su surgery and wound.
It makes sense to me. But pain isn't fun.
The arachnoiditis has flared some. Maybe because of the spine surgery. I never know for sure. It just happens.
You are right to be super diligent about keeping the teeth clean. And it takes more than brushing. But there isn't a substitute that works as well as your own teeth. Also the mouth is full of bacteria that has been proven to affect the heart.
I haven't heard from Susan . I hope she came through this ok. It seems sometimes there is just one more mountain to climb.

[titaniumed]

You are right Ed, with that virus on the attack we all need extra precautions.

Jackie, I was talking about bacterial infection resulting in implant infection, not coronavirus.....Staph mostly, attaching to our hardware.... Staph is everywhere.

For coronavirus, I have read that chances are that most of us will get exposed sometime over the next 2 years...I dont think there is anything they can do for virus....Several companies are working on things, with testing on humans (In China) starting in April. Inovio Pharm is one of the companies.

Rita, here is a checklist for implant infection.
https://www.asra.com/page/217/checkl...ant-infections

Ed

[jackieg412]

I know that staph lives on us. The common skin staph is what my culture showed. I have had several types of antibiotics . I'm not on anything now.
The wound has healed very quickly once the hardware was out. They called it an internal pressure wound. The nurse for the neurosurgeon said it was the first time he has seen one. I do admit it was weird. It is also a very unusual shape. It is like a n extended year drop that is side ways. I am thankful that I had it accessed right away. It took time to develope. It is craziness.
Hope you are doing okay.
Any word on Susan?