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Internal stitches working themselves out :(


I really can't complain much about my recovery from single-level ACDF. It's been really smooth.

But this weekend I noticed my incision was getting a little red. I didn't think much of it and was going to wait til my next scheduled appointment, which is in only two days. My mom convinced me to e-mail a picture of it to my surgeon's PA. I did and she called me immediately. She said neck skin is thinner than other skin and mine, in particular, is even thinner than the norm. (Not the first time I have been told I'm thin-skinned! Ha!) She said it looks like the internal stitches are working themselves out and causing an infection, which is concerning. Even though tomorrow is her day off (Columbus Day), she is coming in. She said she will have to remove at least one of the internal stitches and might have to re-open the whole incision, remove all the internal stitches and irrigate the wound. Also she prescribed antibiotics for me to start taking immediately.

Anybody else have this done? How big a deal is it and how painful is it if I have to have it re-opened and irrigated?

C5/6 herniation, type 2 diabetes, generalized anxiety disorder


  • kinpainkkinpain Posts: 958
    edited 10/13/2014 - 1:59 PM
    Not waiting for your appointment, but contacting the PA and emailing her your picture. She sounds like a conscientious person, so most likely you will get good care. Personally, I don't ever had a similar experience, but a short while ago somebody was posting about an infection of her incision, that had to be opened and treated aggressively. She ended up going to a wound clinic. A member, who is a nurse, gave her some very useful advise to make these treatment sessions easier. You may want to do a search on wound infection, wound clinic, infected incision, etc. Good luck!
  • Well ... it turns out my body was indeed rejecting the not-yet-dissolved internal stitches. The PA was able to pluck out a couple stitches that were already poking through the skin. It hurt a little but no big thing really. She couldn't tell if the redness was from irritation or infection. I told her I've been having throat pain again and she said that could be a sign of infection but unclear. She gave me an antibiotic and told me to keep the incision covered for two days because it bled a little when she took out the stitches. I have to go back next week to have it looked at again.

    The PA said it is rare for the body to spit out internal stitches like mine did. She said she has only seen happen four times. In three of those cases antibiotics and plucking out the emerging strands worked. In the fourth case, the incision had to be reopened an irrigated under general anesthesia. She said this isn't likely but she wanted to mention it just in case. Ugh.

    Right now the incision is still a little red and painful so I don't know. We'll see.
    C5/6 herniation, type 2 diabetes, generalized anxiety disorder
  • How are you doing with this? I have been wondering but I haven't been able to get online this week due to my mom's surgeries. I hope its clearing up. I had a couple of stitches work themselves out early but nothing came of it.
    Tracie C
  • Every time I have ever had internal ' disolvable' stitches they have worked their way out. Either my surgeon didn't use them this time or I have gotten extremely lucky so far. My body does not disolve stitches for whatever reason.
    Best of luck.
  • Well ... I was doing better but now the last few days one part of my incision is a tiny bit pink again and it is just the tiniest bit sore when I touch it. Should I have NO pain right now at the incision? (Six weeks out.) Wondering if I should be concerned or not.
    C5/6 herniation, type 2 diabetes, generalized anxiety disorder
  • This is a good time to call your surgeon'so office and ask. It could be nothing, but any sudden sensitivity and change in color could indicate that something is not right, so it is best to follow up on it.
  • MaregoldMMaregold Posts: 46
    edited 10/30/2014 - 9:34 AM
    I woke up yesterday to discover that I had a red, swollen area right in the middle of my incision. To make matters worse there was an 1/8" black circle at the base of it. I am certain that when I brushed my teeth the night before it was not there. I called the NS office and they had me come right in. They opened and irrigated about a 1/2" of the incision and put me on antibiotics. Apparently I may be lacking the enzymes that dissolve this particular brand of suture. Lucky me! I have also noted a clicking sound when I move my head up and down. The PA said that the sound could be an internal suture catching on the hardware. Yuck!! Oh, well, minor inconveniences considering I drove 50 minutes there and back with no pain, numbness, or tingling in my shoulders, arms, hands, or back! How far I have come in 7 weeks!
  • I am so glad that despite of a bit of a set-back, you can see the big picture, namely that you are better after your surgery then before. It is too bad about you lacking this enzyme, but this is the kind of thing that is impossible to predict. Hope from now on it will be sooth sailing. Wishing you the best!
  • I started having a bit on one suture coming out at the very end of my incision, but so far that and the top still being slightly open, I haven't had complications. I am still having soreness over my incision as well but PT is helping with that I think. What has me the most concerned is that I am having fairly consistant pain from just above the incision to slightly below, and it is spreading out to my hips. I plan to call my surgeon on Monday. Hope your incision is healing better Newsgirl.
  • Dea-Lynn,
    At this point you should not have any open areas in your incision. I would not wait until Monday, I would call the on call doc first thing in the am. They may want to see you sooner than Monday.
  • Thanks, I will. I kinda checked it in the mirror this morning and I cant really tell if it is still open though it is a little red. It has stopped seeping though.
  • Good to hear that it is no longer draining. Keeping it covered will help make it easier for you to see even the smallest amount of drainage. Your surgeon will want to know what has been going on so that he has the option to make changes to your plan of care if necessary. My incision has now closed, but I continue on antibiotics. I hope the rest of your weekend is uneventful. Please keep us updated on the results of your call on Monday.
  • When I called the doc, his nurse said that she was fairly certain that it was my body rejecting the internal sutures but to keep it covered and if it starts to get hot, red, I start running a fever, or if the drainage increases or continues to call them back asap. She did say that she would speak with my surgeon to verify and if he wanted to change anything that she would call me back. Today at PT after the therapist was working on my back he noticed that it began to seep a little but that it was clear and told me the same thing. So unless things change between now and the 17th I'm just going to keep the top covered so I can watch the drainage. My only other major concern is that I am almost 2 months out and the pain while definitely down from immediately after surgery it is back to at least as bad as pre-op. Which I have also discussed with my surgeon at my 4 wk post op and he did say that we would revisit after some official but limited PT.
  • I had just completed the first course 2 days ago and yesterday my incision was red, swollen, and draining again. Back on antibiotics for me.
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