take the antibiotics or no?

[tuansprincess]

So Tuesday before last I knocked my chef knife off the counter. It fell blade down and bounced off my foot. I slashed my skin and nicked my tendon. I had the doctor stitch it up and they said to come back in 10 days to get the stitches out. After 7 days it hurt a bit more than usual. I took the bandaid off and it looked like one of the stitches was getting infected.  I have been putting an organic healing salve to which I added lavender and tea tree oil on it every day.  Two days ago a red spot appeared next to one of the stitches.  Yesterday it hurt a bit more but not too bad.  This morning it was very stiff and sore.  It just got worse all day and swollen.  I went to the doctor and he looked at it and couldn't tell if it was infected or my body getting irritated by a foreign object (stitches under the skin that will dissolve).  He said these could take up to 60 days to dissolve!!  He took out one stitch but didn't think it was healed enough to take them all out.  He wants me to wait at least 5 more days but if it gets redder to come in sooner.  It really hurts now - I can't even put weight on it. 

To my question:  he gave me a prescription for antibiotics "just in case it is an infection".  But I've been working so hard to heal my and Beth's gut healed.  Would these antibiotics just screw everything up?  And if I don't take them what are the risks?

[katelove]

Yes, that sounds like an infection and yes, I think you should take the ABs. You could expect disolvable sutures to be mildly inflammed but it shouldn't be more than vaguely irritating not so painful you can't weightbear.

The fact that you have tendon involvement makes this potentially very serious. I'm surprised you weren't given antibiotics when you had it sutured originally (unless it was done in theatre after a thorough wash out). Because tendons typically have a, relatively, poor blood supply it can be very difficult to clear up an infection. Worst case scenario would be loss of the tendon. It depends which tendon it is as to the degree of loss of function you would experience if this happened.

I just asked my DH about this (he is an ED NP) and he said that standard practice in Australia for an infected tendon would be a referral to an orthopaedic surgeon for washout under general anaesthetic, possibly leaving the wound open to heal by secondary intention, and a course of intravenous antibiotics.

I don't mean to scare you with this but please do start the antibiotics ASAP and, if there is no (or minimal) improvement in the next couple of days then I'd also suggest you get it reviewed again. Probably not by the same people who saw you originally.

I can't say what effect the ABs will have on your gut. A probiotic may help.

[tuansprincess]

thank you for your input.  I have started the AB after no improvement and increased swelling overnight.

[Doodlebugsmom]

I think I'd try some hot soaks or compresses with epsom salt. I would also absolutely take the antibiotics, and I'm a firm believer that they're mostly overused. I wouldn't want to mess with that type of infection, though.

[momofmine]

S boulardii is supposed to be really helpful to protect the gut if you have to take abx.  It is a beneficial yeast and therefore is not killed off by the abx like many probiotics would be.  If you do a search for it, you will probably find some good info. 

[tuansprincess]

doodlebugsmom - I can't get the stitches wet, but I had forgotten about epsom salts.  I will mix/disolve some into coconut oil and rub it on the surrounding area.

momofmine - thanks for the info.  Off to research it!

[hippiemom]

I would take the AB's and keep the stitches very very dry and clean, no salves or anything on them..  There is no need if you keep them clean and covered with breathable dressing that is changed regularly, and are taking AB's to kill what sounds most definitely like an infection.

Any salve is going to keep the wound moist and attract bacteria {unless it is Neosporin, but again, I would opt for dry and clean}.  I have had 7 major orthopedic surgeries, one of which went septic in recovery and went downhill very quickly.  Do not mess with it, as the previous poster said, it can turn serious very fast!

I hear your concern about gut health.  Certainly follow your supportive regimens and maybe have a consult with a holistic practitioner after the AB course is done.