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ACDF

sarobiissarobii Kerrville, texasPosts: 1
So, I had a C4-C5 ACDF (autograft & allograft with cage & stem cells. Don't know if autograft or allograft has anything to do with stem cells) on 7-26-16 and went home after 2 1/2 days in the hospital (I was on heavy duty IV antibiotics while in the hospital but not after I was discharged). Around 8-5-16 I noticed my neck incision opening and draining clear fluid. I called the on-call people and they told me to put Betadine on it. I ended up having to have another surgery on 8-8-16 to clean out an abscess that formed on my hardware and also to replace 2 screws that had already backed out in less than 2 weeks. How does that happen? No abscesses anywhere else. The neck incision swab (taken before IV antibiotics) came out positive for MSSA (like MRSA but sensitive staph instead of resistant staph). The surgeon told me that the infection came from the hardware DURING surgery. I don't know HOW he knows that FOR SURE, but the ways things ended up, I absolutely believe the same thing. I had been on antibiotics via IV for a day or two already when he swabbed the hardware. I was in the hospital for a week and on my last day, the surgeon told me the swab from the hardware came back negative. But I don't know if he swabbed the hardware only or if he swabbed the pus that came out of the abscess too. But if he DID swab the pus, surely that would have been positive for something. What kind of "non-infectious" abscess grows on hardware? Or not GROW anything when cultured as it is pus? But, I'm wondering if it was my incision site that got infected first, how did the abscess ONLY form on my hardware and not on my trachea or esophagus or anywhere in between my incision site and hardware? (I do understand abscesses like to grow on broken skin/areas, so maybe it didn't grow anywhere in between because I didn't have any "openings" or a prime spot for it to grow other than on my hardware.) Unless, it's like he told me, that the infection is in the "nooks and crannies" of the hardware where my blood does NOT flow to remove infection. (But how can I have MSSA in the "nooks and crannies" of the hardware if the culture was negative?). I do understand that this could all be in reverse (neck incision site the primary infection site and drained back to the hardware and caused an abscess there and nowhere else because of no other "prime" spot to grow). I have NEVER had MRSA or MSSA and the nasal swabs during BOTH hospital stays were NEGATIVE. I know Staph is everywhere but I like to believe that I'm a pretty clean person and being an RN, I know about all of the germs everywhere. So, all of this combined just makes me think it WAS caused by contaminated hardware &/or tools used during the initial surgery. I have had a PICC line since 8-12-16 and have been receiving Ancef 1 gram 3 times a day at home. (I do it myself since I am an RN.) I was also told I would have to be on PO antibiotics for the rest of my life (since the MSSA is "suppossedly" in my hardware). Sunday is my last dose and I have an appointment with Infectious Disease on Wednesday. Will the MSSA grow back that quickly (3 days) after 24 days of IV  Ancef and just over a week of IV antibiotics in the hospital? This makes me very nervous and scared because I absolutely do not want another surgery until after the fusion is complete and can get the hardware taken out. Being a nurse, I feel I should KNOW the answers, but I just don't. I'm desperate here! Anyone experience similar complications? Am I just too biased / too close to see logic in all of this? Any advice?
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Comments

  • Jenng128Jenng128 BostonPosts: 2
    edited 09/08/2016 - 2:32 AM
     I am 5 months post op from my 2 level acdf without incision complication. I can tell you my surgeon has been asking questions about my incision and now I know why. So sorry to hear of your acdf complications Sarobii. 

    The only information I can give for help with your surgery is the hospital prep testing and thorough assessment appointment  to inform me of staph infections protocol with this type of surgery. I was given information as if I was a cardiac patient, sent home with micro anti scrub wash  2 days before surgery plus my nose was swabbed and tested for staff and my urine was tested for nicotine. Also no aspirin/NSAIDS one week before surgery. 

    Hopefully your hospital followed the same protocol, good  topic for conversation with the entire surgery team who performed your surgery. 

    ~Wishing you more good days than bad.~
  • SavageSavage United StatesPosts: 7,241
    hello sarobii!

    welcome to spine-health
    please click on link for helpful information!
    Sue
    Honorary Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

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