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Why is blood oozing from my stitches?

Saturday, 09 January 2010
Answered by: Prof Suneet Sood
Consultant Surgeon, Malaysia
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Q. I am a 48 years old woman who has been operated for uterus removal last year. After a month of operation I felt a hard ball type collection (like a muscle) at the site of stitches. Then the stitches got swollen and burst with blood and white fluid. I have undergone two surgeries for the same but the problem still persists. Nothing has been diagnosed in the biopsy and culture tests. The fluid and blood still oozes from the same wound. What should I do? Please suggest.

A.  After surgery a wound infection may occur. Pus may discharge. Such an infection usually resolves completely within 4-6 weeks. If the infection does not resolve, there are three major causes. The first cause of a non-resolving infection is an infected stitch. The stitches used during abdominal closure can get infected. Since the stitches are non-living, they cannot get rid of the bacteria, and are a cause of persisting infection. The treatment of an infected stitch is exploration and removal of the stitch. I presume that this has already been done in your case. The second cause of persisting infection is incomplete drainage of the pus. At the time of surgery for clearing your infection, the doctor may not have been able to allow the pus to freely come out. This can result in a recurrent collection of pus. In fact, surgery for such an infection has a known failure rate of about 5%. Unfortunately, the only option is repeat surgery for clearing the pus, and searching carefully for an infected stitch. The third cause is tuberculosis. TB is a rare cause of wound infection, but does occur. If the wound is infected by tuberculosis or other TB-like bacteria, the wound will never heal unless you take anti-TB medicine. Your doctor can conduct appropriate tests to see if you have TB infection. Since you have been having this problem for a year, you must rule out TB.

A.  After surgery a wound infection may occur. Pus may discharge. Such an infection usually resolves completely within 4-6 weeks. If the infection does not resolve, there are three major causes. The first cause of a non-resolving infection is an infected stitch. The stitches used during abdominal closure can get infected. Since the stitches are non-living, they cannot get rid of the bacteria, and are a cause of persisting infection. The treatment of an infected stitch is exploration and removal of the stitch. I presume that this has already been done in your case. The second cause of persisting infection is incomplete drainage of the pus. At the time of surgery for clearing your infection, the doctor may not have been able to allow the pus to freely come out. This can result in a recurrent collection of pus. In fact, surgery for such an infection has a known failure rate of about 5%. Unfortunately, the only option is repeat surgery for clearing the pus, and searching carefully for an infected stitch. The third cause is tuberculosis. TB is a rare cause of wound infection, but does occur. If the wound is infected by tuberculosis or other TB-like bacteria, the wound will never heal unless you take anti-TB medicine. Your doctor can conduct appropriate tests to see if you have TB infection. Since you have been having this problem for a year, you must rule out TB.

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