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I am diabetic. Had surgery and pin placed in leg. Not cured by antibiotic. Could it be staph infection?

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Orthopaedic Surgeon
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Hi. My father had surgery approx 10 weeks ago to have a pin placed in his leg after a fall and breaking both the lower bone and upper. He is a diabetic as well. There was an open wound that did not heal and after five -six weeks, had surgery again to remove the pin. He has been in hospital for a number of weeks now and the wound has ulcerated and is not healing. Doctors have advised my mother that the antibiotic treatments are not working. They live in another state and my mother is asking me for advise as she feels not enough is being done for my father. Is it possible that he has a staph infection? What questions should my mother be asking from the doctors? I still have to ascertain if the ulcer like wound is a staph infection or a venous ulcer or a arterial ulcer or a combination of both.
Posted Mon, 23 Jul 2012 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 6 hours later
Thanks for posting your query.
A non healing wound can be due to many causes infection being the commonest cause. To find out the infecting organism, a wound swab culture can be done which will help in guiding us regarding the antibiotic treatment needed. In diabetic patients, poor blood circulation is an important factor which causes a delay in wound healing.
In cases of injury, a venous ulcer or arterial ulcer is not likely. Since he is bed ridden for a long time, development of bed sores is a possibility.
A detailed examination and if needed local debridement of wound is needed to clear off the dead tissue and debris so that proper healing can take place.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: I am diabetic. Had surgery and pin placed in leg. Not cured by antibiotic. Could it be staph infection? 12 hours later
Hi Dr Tayal.
Thank you for your response.
Today the results were given t my mother and the cause of the three open wounds/infection is, Enterococcus Faecalis and Enterococcus Faecium. This would explain why the infection has not responded to the antibiotics he has been given over the past few weeks.
Besides combining a treatment of ampicillin or penicillin with aminoglycoside, how should the open wound that is infected be treated and dressed?
Is there a real risk of lower leg amputation due to his diabetes (the wound is just above the ankle) ?
Due to his heart problems and bypass surgery a couple of years ago, is there a risk of endocarditis?
I look forward to your reply.
Answered by Dr. Praveen Tayal 15 hours later
Thanks for writing again.
Along with the antibiotics he is already getting, regular debridement of wound and cleaning with peroxide will help the healthy skin to cover the wound fast. Local antibiotics like fusidic acid will also be helpful. Dry dressing is preferred in such cases.
In case the blood supply is poor and his toes and the wound margins are turning black then amputation might be needed.
Endocarditis is not expected when he is getting adequate antibiotics regularly. Please do not worry. Since the infecting organism has been detected, he should be fine soon.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Above answer was peer-reviewed by
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