Sternotomy Wounds and Internal Suture Rejection

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I had my OHS 5 weeks ago (28 year old male, St. Jude mechanical valve and Dacron graft implanted via the Bentall Procedure), and so far my recovery has been mostly straight forward. Aside from a pesky Atrial Fibrillation (AF) episode,which was successfully treated, I've only had one other concern (which I have found to be rather worrying); my body seems to be rejecting sections of the internal suturing beneath my sternotomy scar.

At first my wound seemed to be healing quite well (although I guess it's hard to determine that at this early stage). At around the second week after coming back home, I developed two small weeping sores on the upper part of my sternotomy scar (the holes were ~1mm across, and about 35mm apart). I squeezed a small volume of puss out of them while showering, and then painted the wound in betadine (something I have continued doing each time I wash the sternotomy scar) and went to my GP the next day. He investigated the wound, took a swab and prescribed some antibiotics (which were cancelled the following day when I was admitted to hospital for my AF episode).

By this point the two sores had started to heal and scabs had formed. Which was fantastic, except for the lower sore, which formed a small hard white scab. At first I simply assumed it was just a dried plug of puss (gross, I know), but when it didn't change in size after a couple of weeks, I started to become a little curious as to why. I had a shower and did something stupid (picked at the scab), and discovered that it was in fact a knot of internal suturing that had come to the surface. I was now the proud new owner of a piece of string sticking out of my sternotomy scar. Yay.

I already had an appointment booked with my GP the next day to get my annual flu shot and asked him to inspect the area of concern (If I didn't already have an appointment with him, I sure as hell would have booked one). He told me that it was indeed a section of my internal suturing, and that it needed to be removed so that it didn't lead to an infection. So he removed the suturing (there was a knot of suturing with at least an inch of suture string on either side of it), and patched up the tiny wound, which proceeded to heal in a way that I would consider 'normal' over the following week (it hasn't fully healed, but appears to be on its way to doing so). Unfortunately, this wasn't the last time i'd have the pleasure of going through this.

around 5 days later, i noticed something in the scab of the other weeping wound (the one that appeared to heal 'normally' at first). There was a white strand of suture string that had worked it's way to the surface. So again i went to my GP to get it checked out, and sure enough, it was another piece of suturing that needed to be removed. This piece was a little more impressive, at 4" long. I haven't experienced any more pieces of suturing attempting to escape, but I'm still concerned (I really don't want to have to go through an infection, especially after reading what Pellicle had to endure).

Has anybody else experienced anything like this? Is it something that could be considered normal?
 
Don't know if it's the same thing but I have internal sutures that have not dissolved. My surgeon said he could remove them when I saw him in February if they didn't dissolve. In fact, I intend to make an appointment with him today. But no pus, draining, etc. just the wire poking out and noticeable.
 
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Hi

you know, I have this strange memory from my first operation of having a suture visible, they went away over time with no lasting effect. I can't be sure how long that was after surger cos I was 10. I'd say that you should keep a close eye on it (and I agree with the bedodine wash) and discuss with your medical team to
  • swab some of the areas and instruct them to specifically culture for propionibacter acnes. Further iterate to them that you know that culture times on Propi are longer than a week and may require a multi pronged approach with differing growth media
  • after the swab has been taken consider a good and lengthy course of antibiotics. That will confound future swabs to see, and you may be better off just "waiting and seeing".
If you feel inclined to take some images and post them (I use flickr to host my images and put them in here with img tags) I could probably make a better guess.

Its bed time here, so perhaps see you in the morning
26601235686_809e93a7e3_b.jpg
 
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