ACDF incision questions

[I tried to make this as short as possible but realized folks would ask questions so I gave as much info as I could without including the names of my dogs]

On 8/30 I had ACDF done to fuse C5/6 - 6/7. The incision was coated with some sort of sealant. I am allergic to adhesives and I don't know if it was this sealant or the tape they used around it (yes, it was on my chart to not use tape) but it itched like the beejeebers. On day 5, I was gently scratching near the incision when I accidentally lifted up one edge of the coating. That gave me something to pick. I didn't mean to, it just happened. By day 7, I had picked off the entire coating. The itching stopped soon after. Could be the pulling on my skin?

The incision had already been leaking under the coating which was stuck only at the edges. The leaking continued. We discovered a stitch sticking out from one end and that was where the leaking was coming from. The drainage was clear to yellow to look at but bright yellow on the white gauze. The leak would stop and start randomly, even skipping days.

On day 13 I had the wound check up appt but they were more concerned about some symptoms I was having. He mentioned the missing coating, fussed a little, removed the stitch, said to keep it covered for another 7 days, and that was it. This was a Monday. On Friday I was at my desk in my chair (I use a power chair with headrest) and was without brace and gauze, giving everything a breather (it was a very hot day). I felt a tickle on my throat then down my chest. I put my hand up and realized it was wet. The wound had opened and a brownish discharge was pouring out. The ortho office couldn't see me and sent me to the ER instead. Several hours later, I finally was seen. By that time, of course, no draining was happening. He recommended ibuprofen for 5 days at a high dosage and gave me a rx for Kephlex in case it became infected. He said it was serosanguineous fluid, almost as if I was allergic to the glue or the internal stitching. He said to see GP if it continued or if I had further questions. I went to see GP, of course. GP said to start antibiotics because the incision looked angry and red at that point and she didn't like that I'd been running a temp of 99F since the surgery. Not at all usual for me. The hole in the incision was very small at this point, and was almost closed.

Since then, the wound has continued to open and close, draining the yellow fluid every other day or so. Earlier this week, it had stopped again and I thought it was done. Until I realized it was bulging and white where it usually leaks (where that stitch was). I looked at it and gently pressed on it to see if it was hard or soft and it basically exploded. The hole remained the small pinhole it always has been but now it had pressure behind it. The stuff that came out was hot and a mix of the yellow and a chunky white. It did not smell like pus at all. It smelled burnt? Went back to see GP who has ordered a CT scan to see how much fluid is in there and where. She also did a culture although by then, of course, the white stuff was no longer draining.

Usually, I feel this pressing against my throat the grows. The wound drains a little and the pressing eases a little. Then it grows, it drains, it eases. The pressure has been on the left. Once that white stuff started, the pressure shifted to the right and has not gone away.

I am sooooo tired of all this. The draining. The pressure feeling. The neck brace. The gauze I must keep around to keep wiping my throat with. I can't wear anything but Henleys or other button up shirts because I can't stand to have anything touch the incision.

I see the doc Monday (10/10).

So my questions are this:
has anyone else experienced this? the constant leaking?
is he going to say it is all because I removed that itchy coating thing? is it?
my GP and I feel it is fluid based near the front of my throat since that is where I feel the pressure. If the fluid was coming from the back, would it make its way all the way to the front?
my GP said fistula but did she mean seroma?



  • I would be surprised if your issue is simply from removing the glue (it is super glue), although it does provide a protective barrier.  I was told to let it flake off on its own, but the surgeon was surprised it was still there after 4 weeks.  He said I could just gently rub it off.  He also said if a stitch (internal dissolving sutures) poked out, to just pull it out.  It never happened to me.

    As far as the drainage is concerned, I'm thinking that is the major problem.  Sounds like an infection if it was hot and red and required antibiotics. Definitely keep on top of it in case another round of antibiotics is required.  I personally had no drainage and never wore any dressing after Day #2.  Sorry you are so uncomfortable. 
  • PaulaOPPaulaO Asheville NCPosts: 4
    The fluid has been swabbed and it is a penicillin resistant staph infection. I am on a sulfa/trim antibiotic right now. The GP and the surgeon's PA are in disagreement on how to proceed. I had a CT scan done yesterday. I love having tests done on Friday. They make for such lovely weekends, don't they? I suppose it depends on what that says as to what happens next.

    It has not leaked since Monday but is still puffy and the incision is red. I cannot stand to have anything touch the incision. I'm stretching the collar of all my tee shirts.
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  • I can honestly say, I never had any of that happen. I had a darin hanging out of my neck in the hospital. Plus IV antibotics every 4 hours during my 3 day stay and pill antibiotics when I went home. Keflex 3 times a day for 15 days. My doctor has a 0% infection rate. My glue scraped off in a week after I pulled the steri strips off. No issues. 

    This may sound strange but is it possible to somehow collect some of this stuff that is draining from your incision to show doctors? 

    I wish I could say, Yes! That happened and it was such and such. I truly hope you are ok and someone finds the cause quickly. 

    Please keep us posted! 
  • Oh just read it the fluid was swabbed! Holy cow. 

    I hope you feel better very soon. 
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