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Hole at top of incision

kaylafowlerkkaylafowler Posts: 9
edited 06/11/2012 - 8:58 AM in Back Surgery and Neck Surgery
I posted last week that my doctor thinks that the top stitch in my incision had abscessed, and that there was fluid leaking. Well, I have been on an antibiotic for a week tomorrow, and the redness has gone away and there is no more fluid leaking. The doctor said it looked like a superficial infection, but cultured it to make sure. I haven't heard anything yet, but assume if they got it back, and it wasn't just superficial, they would have called me.

My question now is, there is a hole in my back. It is at the very top of my incision. When I saw the doctor, he said to keep a band aid on it and to only take showers so that it is not submurged in water. But now, there is literally just a hole in my back. It isn't scabbed over or anything...just a hole. Will this close up on it's own?

I had my 2nd plif on 11/1/11. I had a plif 11/1/10 and never had any problems with my incision. Help!


  • I would call your Surgeon about it and show him the hole. It may need to be packed with guaze daily by a Nurse to heal it from the inside out depending on how deep it is or steri strips but he needs to see that opening. I hope the infection has cleared up and you heal completely. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Thanks Charry! I have an appointment to follow up on the 21st, which will be a few days after I finish the round of antibiotics he put me on. I think I might call tomorrow any way and talk to his nurse. Like I said, my concern is having an opening, and if it doesn't heal, I will just keep getting infections. Thanks again for your help!
  • The surgeon will definitely need to know how deep the hole is. Sometimes the internal dissovable sutures get recognized by your immune system as a foreign body, they make a little pimple of pus (neutrophils) and a small area of redness that "looks infected" but is just the body's white blood cells see that internal suture as foreign/something that shouldn't be there and tries to attack it. These neutrophils typically breaks it down the suture sooner that absorble sutures normally dissolve. Was the pimple "pops", when the pus & small suture particles are wiped away there is a hole there - usually is only about 2-3mm deep, not more than 4-5mm. These heal easily by keeping a little ointment (your doctor may recommmend an antibiotic ointment) on a telfa pad. When (patients and docs) see these pimples they usually think infection, but this suture reaction is not an infection. From your description it sound like it might be this. Some antibiotics can reduce the redness of skin because they are anti-inflammatory, (that's why they are used for acne), sos reduction of redness doesn't necessarily mean you had an infection. Its better that your doc was cautious though.
    Sometimes, one of the more superficial internal sutures can accidentally tie off a small blood vessel (artery) to the skin during closure of the wound. When this happens, that small area of skin can die served by that blood vessel can die, and it forms a small but thick black scab. The size of scab (and later hole) is a function of the size of the blood vessel ties and the skin it served. It can be red around it too; its also technically not infection but dead skin is a good breeding ground for an infection.
    The bad (worst) type of post-op "hole" is a sinus tract, and its a direct connection from the outside world into your surgery site - not good! Its my personal biggest fear with drains and I actually picked my surgeon for my second fusion that wouldn't use a drain (I know some surgeons insist on them to prevent fluid build-up that leads to infection). Sometimes, the only way to see how deep the hole is, is for your doctor to numb you with a little local skin anesthetic like lidocaine and insert a sterile probe (a culture is usually done at the same time). Rarely, if a sinus tract is suspected a dye can be injected into it and it can be looked at radiologically.
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