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Arteriogram incision healing: concerned about wound care
I am my wife’s caregiver. She has a blood clot in her heart and is being treated with thinners. About a month ago, my wife had an arteriogram. The access to the femoral artery is in the left groin and was closed with a Star Closer. The Closer fell off about four days later. She is obese so belly fat laps over the incision when she stands or sits. We clean the incision with soap and water, as directed by our physician. Here’s the issue. She is immuno-compromised due to high dosage prednisone so we were advised that the incision healing would be slow and should heal from the inside to the surface. We leave it open to air while she lays down and as directed, we put a bandage on when sitting or standing. The incision opening looks to be about a quarter inch deep. It doesn’t look infected but there is pus inside. Oozing stopped about two weeks ago. Our surgeon looked at it a week ago and noted “a little infection”, told us to keep cleaning it with soap and water and avoid antibiotic salve. While the incision surface is not red or hard, the open hole and pus is worrisome. Our surgeon said it could take another month to heal. So, does this sound normal under the immune deficiency and does the belly fat lapping over impede healing? Thank you.
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@ernpick1 Welcome to Mayo Connect. I salute you for being so caring and knowledgeable about your wife’s condition. Now you are wondering about wound healing. I found this article that says lots about wound healing, almost too much. If you scroll down to the last section, it talks about diabetes and wound healing.
https://sitn.hms.harvard.edu/flash/2013/issue133a/
And, yes, immunosuppressive drugs also delay wound healing. Keeping the wound open to air as much as possible is very important. As the wound heals and you wash it, be sure to not disturb and new tissue or scabs. Can you wife help at all? Are you or she able to hold the belly flap out of the way when she is up? Maybe the surgeon could ask for a home care nurse to visit your home once or twice a week. She could assess the wound and give suggestions.
Are you doing anything special to take care of yourself?
Thank you so much for the very helpful info. Things look much better today. I didn’t consider diabetes and slow healing.
I am okay. Thankfully retired. I don’t what we would do if we relied on family medical leave.
@ernpick1 you may be retired but you’re working hard! Please take care of yourself and do something special . My husband was/is my caretaker, mostly by doing all the things i used to do. I know it’s exhausting, so i make sure he’s able to take his camping/fishing trips whenever he wants to.
Are you able to check your wife’s blood sugar every day and keep a record of it? Any infection will cause the blood sugar to rise. Between diabetes and prednisone, infections can be dangerous. Just keep close track of things and call her doctor when you need to.
I can tell you love your wife and doing a great job. I’ll be thinking of both of you so will you stay in touch>
Thank you. We do ck blood sugar and so far it is normal. She takes Glipizide, going on four weeks. I chart every pill, pulse/ox, Bp and eye drops.
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1 Reaction@ernpick1 Wow! You chart everything! That is fabulous. Were you a nurse at one time? If you don’t mind telling me, what caused your wife’s blood clot?
I was never a nurse. I am a writer/journalist and our physician staff advised us to chart. Heart issues run in her family. One morning she woke up with double vision. A series of tests revealed atrial fibrillation which over time led to the clot. The pressure caused a reaction between a tiny vein and the carotid artery that opened the fistula behind her eye orbit and damaged her vision.
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1 ReactionErnpick, I just wanted to stop by and see how you and your wife are doing? How is the incision healing going?
Thank you, Colleen. The incision is about the same. I spoke with the surgeon’s nurse yesterday and she said that due to the prednisone and diabetes it could take several weeks and to keep it clean and open as much as possible. It doesn’t appear to be infected. We have a procedure on Nov 1, to see if the clot in her heart has dissolved. I will ask the staff to have a close look at the incision.
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1 ReactionI'll be interested to learn what you find out at your wife's upcoming appointment. It's been a few days since we last exchanged posts. How are things today?
Thank you, nothing has changed. The incision isn’t worse but is still open. She is very weak. We will probably request transport to the clinic on Monday for the procedure.
We live in a split level three level home and stairs are involved. She is on the top level which has a bath and toilet.
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