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Is Black Skin A Sign Of Infection After Removal Of Plantar Fibroma?

Posted on Thu, 26 Dec 2013

Question: I had a plantar fibroma removed on November 21. The first picture is 4 days post op the second one was taken today, 11 days post op. The black skin is very alarming to me. I saw my surgeon today and although he said it was not great it still needs time to heal. He said it could also become a pressure sore. I am worried that there is an infection or the skin is necrotic. I am debating going to the ER to have it further looked into before it becomes a major issue. Do you have any medical advice - i would like a second opinion

Answered by Dr. Dr. Ivan Romich (29 minutes later)

Brief Answer: Hi and welcome to XXXXXXX Detailed Answer: Thanks for the query. This is skin necrosis and probably surrounding inflammation around it. This is definitely abnormal healing and it requires more detailed evaluation. Such healing complication is usually seen in elderly,diabetic and immunocompromised people or in those with bad leg circulation due to atherosclerosis. If you are not any of them,I have to say that this clinical picture is rarely seen. Also, it may happen if there was affected circulation during surgery so some vessels may have been injured. Now, as I can see this is probably superficial skin necrosis and in healthy people it will dry and fall,and healthy tissue will grow under it unless there is some significant circulation insuficiency. In this case there may be deeper necrosis with inflammation and you need to consult plastic surgeon and this wound must be reoperated. To evaluate this,you should visit hospital and do blood inflammatory markers, legs doppler ultrasound and then surgeon will evaluate is necrectomy necessary. Also, you probably need antibiotic treatment and hydrocolloid dressings. Stitches should be removed as it is not functional anymore. YOu should also avoid pressure on this scar. All in all,this is severe wound complication,but in young and healthy people there are no serious consequances. However,you should do tests and follow my recommendations that I ve mentioned and consult doctor to prevent possible progression of infection and necrosis. Wish you good health. Feel free to ask.Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Ivan Romich (6 minutes later)

I am a healthy 25 year old female. I have no prior medical history. I do have some tingling in my foot, but am just concerned with the black color. My next appointment with my surgeon is in a week and a half, you feel i should have this looked at immediately? My major concern is that the skin that was once pink is now black and the area seems to be growing

Answered by Dr. Dr. Ivan Romich (14 minutes later)

Brief Answer: hi Detailed Answer: you should visit doctor today. This is skin necrosis with surrounding inflammation and it may progress to serious infection and phlegmona. YOu need to start antibiotic treatment today and maybe necrotic areas should be removed surgically. Also,stitches should be removed. You should not wait 1 week definitely! This is my suggestion. I am not saying that it wont heal by itself,but antibiotics and closer evaluation by doctor is definitely necessary.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar