Blisters following orthopedic surgery?

Question

I am having a hard time finding information on the net about this condition. Does anyone know how common it is for patients to develop blistering of the skin following joint replacement surgery (arthroplasty)? I think they are called fracture blisters. Is this a serious complication or something that usually resolves itself?

Answer 1

Tape blisters around the incision after a total hip arthroplasty can be a source of pain and frustration for patients. Blisters can occur esp when non-stretchable silk tape was used to secure the postoperative dressing. Superficial, blisters can occasionally lead to infection or leave scars.

Blisters may form because of the use of constricting tape or because of swelling and/or skin sensitivity. Patients who have experienced the development of skin blisters after previous surgery may request that paper tape be used after subsequent surgical procedures, but paper tape is often poorly adherent to the skin.


Sometimes, shear stress or the pulling of the skin that occurs with the use of a more rigid tape is associated with the development of skin blisters. This can be prevented by the use of a more compliant or stretchable tape.; or compressive spica Ace wrap dressings.


This type of dressing does not restrict skin movement as much as a more rigid, non-stretchable tape dressing, but the application of the compressive spica Ace wrap dressing is difficult and dressing changes are not easily performed, particularly in obese patients.


Postoperative swelling may also contribute to the formation of skin blisters. Skin blisters are not uncommon at fracture sites where a closed reduction has been performed and there is associated post-reduction swelling. Plaster cast left for a long time can also cause blisters.

In addition, nutritional deficiencies, obesity, or other medical comorbidities that often times cannot be improved before surgery may contribute to the risk of the formation of skin blisters.



When skin blisters do develop, treatment with protective dressings and observation for signs of infection are appropriate. Time for healing may vary. Blood-filled blisters may be more likely to heal with permanent scarring. So, make it an effort to avoid scratching. Keep the area clean and dry.


Skin blisters would not be expected to compromise the results of arthroplasty with regard to long-term function and may not represent a serious concern for the surgeon. However, they can be a very disconcerting problem for the patient, who often requires reassurance from the surgeon that the blisters will heal. This problem might represent a frequent cause of postoperative morbidity and patient anxiety.


I recently had abdominal surgery. I notified the surgeon that I was allergic to silk tape. He used nylon tape right at the suture sites for security and paper tape. In a short duration ;post surgery, I experienced some burning and itching at the incisional site. Eventually, blisters were formed which burst with fluid. Now I have some burn or discoloration scars which I'm treating with Mederma to lighten. I should have used it immediately. I did apply some Neosporin (antibiotic oint OTC) to aid in the healing process.

By the way, this is a common problem. Fracture blisters maybe formed at the site where closed reduction ( no surgery) is done. And the blisters you have won't be called that as you had a joint replacement surgery or arthroplasty.(open) Therefore, remove the offending tape immediately to avoid scarring. You can also apply petroleum jelly oint, and keep the suture line dressed if it's draining.

Answer 2

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Is this an infectious disease manangement consultatant? If so, then I would follow their advice. Since you are on flucloxacillin then the chances of you developing a secondary infection leaving the bandages intact is not likely. However, removing bandages can disturb the necessary clotification needed to heal wounds. Removing bandages can also expose wounds to other sources of infection that are air borne. The Yellowish-brown discharge you are mentioning sounds nothing more than serum mixed with a small amount of blood , which in such surgical orthopaedic procedures as yours, is pretty normal. I would say that the blistering sounds as if you may have had a reaction to the actual surtures or any antibiotic ointment applications that they may have applied. If you don't have any other symptoms such as redness, swelling, warmth or copious fluid drainage, I wouldn't be concerned at this time. The antibiotic your taking is high spectrum and should systemically ward off any infections your concerned about. If your concern is over-whelming then by all means ask for someone else to look at it at your next visit and get a second opinion.

Answer 3

A lot of interesting things come out of large healing wounds, most of them are normal, some are not. Wound drainage comes in many forms and some can be alarming at first. This is the by-product of healing that you will start seeing in the wound at about 5 days post-op. At first glance, you may think you have an infection since there will be little gobs of "gunk" in your wound. Exudate can be white, yellowish, grayish, greenish or light brown. Exudate can also have a slight odour, it is normal. Strong odour with pain, redness and swelling usually indicates infection, in this case call your doctor as soon as you are able. However, Inappropriate use of surgical dressing may cause blisters around the surgical wound and increase the incidence of peri-operative wound infection. Two different dressings Opsite post op or Mepore were applied by a single surgeon on 100 patients (50 each group) undergoing same arthroscopic procedure of the knee under general anaesthetic were included in this study. They were followed up, up to 10 days. An independent nurse practitioner evaluated the complication related to the dressing and assessed the satisfaction with the 5 item short questionnaires at outpatients clinic. Blisters developed in 6% of patients with Mepore dressing (p=0.24) and none with Opsite Post op. 14% Patients with Mepore dressing developed superficial inflammation and this is significantly greater (p<0.001) than opsite. 86% patients with opsite dressing on were able to take a bath and thereby reduce the chance of contamination from the skin flora. 90% patients with opsite rated the dressing as excellent compared to mepore 26%, (p<0.001) There is quite a high incidence of blisters forming under tape of many different types. However as you do not state whether your dressing is taped, there can be no discussion along that subject. It is often the practice to keep the dressing on a surgical wound for up to two weeks or at least until the first review with the specialist. Your consultant, having stated that the blistering is not usual, likely knows or has found out the possible cause and should address the problem when you next see him / her. Hope this helps matador 89

Answer 4

blisters orthopedic surgery

Answer 5

That might be a infection. Anytime you have skin that blisters after a serious surgery is something to worry about. I would call your doctor or nurse practitioner and discuss it with them. Good luck!

Answer 6

Blisters can be caused by the type of dressing that us used post op. If they are using a traditional adhesive dressing they only adhere to the top of the skin cells so they have to stick harder unlike a silicone dressing that is much more conformable and adheres to the dips and valley s of the skin. The reason they use traditional dressings is unfortunately due to cost. Compared to the cost of the surgery the dressing shouldn t even be a factor, but it is. Mepilex Border Post Op has clinical evidence supporting the minimization of blisters compared to Aquacel Surgical AG.

Answer 7

forget the internet, call your surgeon.