Post excision infection, developed within 48 hours was almost septic.

[candrews922]

What is the name of your state (only U.S. law)? NY
I typed up a long thread and only my title showed up. I had previewed it also, so I am not sure where it went. I am posting again. In December of 2010 I had a biopsy done by the plastic surgery department of one of our local healthcare networks. It was done by a PA, and from the start there were issues. I have never had a skin biopsy before. The site didn't look like any melanoma I had seen in pictures. The PA did a shaving biopsy, which is like a bad scrape or a burn while it is healing. A single wipe skin prep was done before the biopsy, without iodine. The site didn't want to heal, it was red and sore around the scab. The PA notified me that my biopsy had come back melanoma, and that I would need to have an excision done. I mentioned to him about the site showing signs it was trying to become infected. He said not to worry about it, and had me schedule for an excision. Didn't prescribe some antibiotic, I had been putting triple antibiotic ointment and hydrogen peroxide on it, but it was still inflammed. I had the excision done by the same department only it was the surgeon who did it. I am pretty sure it was on the 18th in the afternoon. I was at their walk-in clinic on Saturday. My arm was grossly infected and I had a fever. The PA at the clinic called the surgeon on call and told him what was going on. He prescribed 2 oral antibiotics and sent me home. With orders that if it worsened I would have to go to the ER. I was in the ER Sunday and had to stay over nite. That whole visit and hospitalization was an absolute nightmare. The wound I had to heal myself at home was horrendous. They didn't even give me the proper supplies to cover and take care of it after I was left with a gaping 2 to 3", by 2", about 3/4" deep crater in my upper arm. That was just like a serious burn. No valid reason given for new skin prep procedure not requiring iodine. Told it takes too long to dry, and usually doesn't make any difference any way. I was a lab tech and we always used alcohol and iodine to clean skin. With MRSA and necrotizing bacteria out there we want to clean less? The infection had to be inside the biopsy site, and was driven down inside the wound during the excision. The only way it could have progressed so rapidly. The on-call surgeon was also a major jerk and traumatized and hurt me because he had to come in on his day off! What he did to me makes me even angrier than all the other stuff I went through with this. It was cancer after all.

 

[Hot Topic]

What is the name of your state (only U.S. law)? NY
I typed up a long thread and only my title showed up. I had previewed it also, so I am not sure where it went. I am posting again. In December of 2010 I had a biopsy done by the plastic surgery department of one of our local healthcare networks. It was done by a PA, and from the start there were issues. I have never had a skin biopsy before. The site didn't look like any melanoma I had seen in pictures. The PA did a shaving biopsy, which is like a bad scrape or a burn while it is healing. A single wipe skin prep was done before the biopsy, without iodine. The site didn't want to heal, it was red and sore around the scab. The PA notified me that my biopsy had come back melanoma, and that I would need to have an excision done. I mentioned to him about the site showing signs it was trying to become infected. He said not to worry about it, and had me schedule for an excision. Didn't prescribe some antibiotic, I had been putting triple antibiotic ointment and hydrogen peroxide on it, but it was still inflammed. I had the excision done by the same department only it was the surgeon who did it. I am pretty sure it was on the 18th in the afternoon. I was at their walk-in clinic on Saturday. My arm was grossly infected and I had a fever. The PA at the clinic called the surgeon on call and told him what was going on. He prescribed 2 oral antibiotics and sent me home. With orders that if it worsened I would have to go to the ER. I was in the ER Sunday and had to stay over nite. That whole visit and hospitalization was an absolute nightmare. The wound I had to heal myself at home was horrendous. They didn't even give me the proper supplies to cover and take care of it after I was left with a gaping 2 to 3", by 2", about 3/4" deep crater in my upper arm. That was just like a serious burn. No valid reason given for new skin prep procedure not requiring iodine. Told it takes too long to dry, and usually doesn't make any difference any way. I was a lab tech and we always used alcohol and iodine to clean skin. With MRSA and necrotizing bacteria out there we want to clean less? The infection had to be inside the biopsy site, and was driven down inside the wound during the excision. The only way it could have progressed so rapidly. The on-call surgeon was also a major jerk and traumatized and hurt me because he had to come in on his day off! What he did to me makes me even angrier than all the other stuff I went through with this. It was cancer after all.

You're telling us about something that happened in 2010. This is 2012. Are you asking if you should file suit against the healthcare network? Against the PA? Against the surgeon? Or are you just venting?

 

[ecmst12]

Iodine is no longer the standard for skin prep, too many allergies. Chloroprep is the current standard in most places. As I posted in your previous thread (that you failed to go back to and edit), infection is a known risk of any surgery and is much more likely to happen from something that occurs AFTER the surgery than before. Did the doctor instruct you to use triple antibiotic ointment and peroxide to clean the site? You could have been making things worse. You are also incorrect that "the only way it could have progressed so fast is if the infection was in the biopsy site and was pushed in during the excision". Not only does that make no sense (the biopsy site was REMOVED during the excision, and a fair amount of tissue surrounding it), but there are plenty of bacteria out there that grow very rapidly. It is much, much more likely that the contamination happened AFTER the excision. But you won't be able to prove when or why it happened, and it does not sound like you received below-standard care at any point.

The items you need to care for a surgical wound are usually available at drug stores, why would you expect the hospital to provide you with all that stuff once you are discharged?

 

[lealea1005]

Well, for starters, I would suspect your Phyician or PA did NOT recommend treating the area with peroxide which may inhibitclarif proper tissue granulation/healing.

Was the antibiotic cream you used water soluable? If not, that would also inhibit healing.

I was a lab tech and we always used alcohol and iodine to clean skin. With MRSA and necrotizing bacteria out there we want to clean less?

It's not cleaning less, it's cleaning different.