I just had to get my hand cut open to put in a couple of screws to fix a broken thumb. They put me on an IV antibiotics afterwards and now I have a month long course of pills to take. What puzzles me is this. The surgery was done in a sterile environment with sterile tools, my entire fore arm is now wrapped in a tight sterile bandage / cast which will stay on for more than a month (or get changed for another one).
How exactly would any bacteria / virus get into the incision? Through the air permeating through the bandage? Assuming I don’t fall with my arm into a puddle of mud I’m just not seeing an infection vector.
Don’t worry I will finish the course of antibiotics, I’m just curious if its actually necessary or if its a “cover your ass” thing by the doctors.
A little bit of both. Bone surgery is higher infection risk than, say, abdominal laparoscopic surgery. While everything used on and in you was sterilized, there could still be resistant bacteria depending on how it was cleaned (autoclave vs chemical), and airborne bacteria that could, on the outside of possibilities, have settled on anything sitting on a sterile tray while waiting to be used. People can’t help a cough or sneeze, after all, and that stuff gets out, even if it’s an away direction from behind a mask.
It’s common for hospitals to switch up their sterilization routines, in order to defeat resistant bacteria, they’ll switch disinfectants periodically for instance. But especially with bone surgery, you don’t want to take the risk. Unlike a skin infection which will become inflamed and obvious early on, a bone problem can brew deep and become systemic/septic before you know there are any observable issues. Hence, antibiotics prescribed to be sure.
Google “Deep Tissue Infection” and look at the images. Some of those people undoubtedly lost their body parts.
Putting those screws in your body cut right down into your meat and bones. It’s not just a surface infection that’s scary. It’s the possibility that an infection might take hold deep down in the open tissue.
As for how the bacteria might find you - the human body is just a bacteria factory with feet. People get staph and other serious infections all the times in hospitals. Nothing is perfect. People make mistakes. Unless it was a clean room like those Feds who grabbed ET, you’re still at risk. Better take your pills and be grateful that we live in this brief window when antibiotics are cheap and effective.
I had shoulder surgery which, IIRC (I’d have to check the report) involved shaving some bone spurs and lesions and I didn’t have any antibiotics. At least not after the surgery and I’m almost positive I didn’t get any in the hospital.
Actually, in this case the drug wasn’t sterile. It came from that incredibly corrupt facility in Massachusetts that was supposed to do sterile compounding, but didn’t, and has resulted in the deaths of many people and the disability of hundreds of others. It was profiled on “60 Minutes”.
You would have been given antibiotics in the operating room - a dose just prior to incision, and the surgeon probably washed the area with some kind of antibiotic solution before closing you up. Did they put in any hardware? If not, you probably didn’t need any afterwards.
In the OP’s case, it was done to set a broken bone, and skin can break without us noticing it. Bacteria can indeed get in through the skin incision, and there is no way to completely sterilize anything, including an operating room.
Osteomyelitis can be hard to diagnose, and even harder to treat. Take the antibiotics.
I can look at the surgery report in the morning and see if it says anything about antibiotics, I’m sure it’ll say, but I know I was released (same day). And, yes, I did get some hardware, 2 anchors (into my glenoid*) to hold the cartilage in place.
As for the staph infection mentioned upthread, that could also just be the hospital. There is (was?) a hospital in Milwaukee that seems to be known for giving people staph infections. I don’t know how staph is transmitted so won’t speculate on how might have happened.
*for those not familiar, your shoulder is a ball and socket, the glenoid is the socket.
ETA, I’m assuming we’re talking about IV type antibiotics, not iodine/betadine or or something they clean the area with pre-op. I mean, took the bandages off a day or two later I was covered with a ton of yellow crap. I would hope they’d do that. FTR, they also asked me to shower with (esp that area) Dial that morning just as an extra precaution.
You think your care was under sterile conditions, what about transplants? But even there bad things can happen.
Sometimes its better to be safe than sorry especially in a hospital setting. I am not a fan of antibiotics; my personal opinion is that they tend to make almost as many germs smarter as the do kill. But if I’m getting opened up, especially in a hospital, I’m not going to complain the same way I do when I have a sore throat; I’m going to fill the Rx and take them.
My gf’s elderly aunt had knee replacement surgery a few years back. She ended up with infection in her bone. The knee prosthesis was removed and she had to live for around a year knee-less. Several months of daily home-nurse visits for IV injections, followed by months of oral antibiotics that caused a myriad of nasty side effects.
After about a year she had a new knee put in and is doing fine now.
The night before, they had me shower, then rub my entire body with antiseptic towelettes and then stand and air dry. The next morning, another wipedown with more towelettes. Then the nurses started scrubbing on me. So it was pretty close!
The incision site in my case was scrubbed with alcohol and antibiotic then wrapped in a sterile pressure bandage / cast immediately after surgery. But yes I do not want a bone infection and I am taking the anti-biotics.