Q: My mother, 57 years old, had a hip replacement surgery two months back. She had a stroke 10 years back due to, which she cannot speak well. She was admitted in the ICU and treated and discharged after 3 days. Since then she is on Deplatt but now the problem is that she has fluids oozing out from her surgical wounds for, which she needs to be taken to the hospital for draining out the ooze daily since a week. All tests have been done like CRP, X-ray and there seems to be no traces of infection. Can she be off Deplatt tablets for a while till the wounds heal? Will it be safe for her to be off deplatt? The orthopaedic surgeon says he might have to open the wounds again after watching for a few days. It would be very traumatic for my mother who also suffers from urinary incontinence. Please suggest.

A:Before you decide to stop Deplatt you will first have to find out regarding the ooze from her wound. Is it truly because of an infection or is it because of serum from blood that collected inside the wound. If the doctor is suspecting infection then he will need to go back in and do what is known as an exploration and debridement. Yes, I know the risks are high considering her age. If it is suspected infection then that is the best option. In such situations surgery may be required and done. If however, it is discharge from a collected haematoma (haematoma is blood which is collected in a close space), at times it may be possible to locate the haemotoma using an ultrasound and if there is still doubt aspiration and culture can be done from there. If it is a significant collection it needs to be aspirated using a syringe and needle. Majority of patients may have no symptoms but in your case there may be an associated pain, fever and swelling and red ness if there is any infection. Blood tests like a white blood count could be high with her ESR also higher than normal. If it is not infection then you will have to be in consultation with her physician regarding stoppage of Deplatt. They are the best ones to guide with this. The timing of surgery then depends on the emergency situation that you have the risks Vs the benefit. By and large make sure there is a 48 to 72 hours gap between stoppage of Deplatt and surgery. If there is no emergency you may need to wait for even 5 days in some cases. The haematologist may also suggest some bleeding tests like; Prothrombintine (PT) and activated Prothrombintine (APTT). The safety of stoppage has to be consultation with your physician.