Tuesday, July 22, 2014

Lateral ankle ligament surgery what you want to know

Tore some ankle ligament?    This is a story of an active male that had lateral ankle ligament reconstruction elsewhere and is here for a 3rd opinion.

Problem:  wound would not close and drains as well as continued unstable ankle.

How solved: removed all prior internal stitches (fiberwire) none absorbable that were used for the ligament repair.    Flushed / power washed the site with 300 liters of pressurized saline to clean any bacteria out.  Sent patient to infectious disease for powerful intravenous antibiotics for 6 weeks.   Repair with none braided smooth and absorbable antibacterial suture with amniotic tissue graft used for reinforcement due infected tissue that had to be removed.

Discussion:  Infections happen even in the most skilled hands and seemingly sterile environments.   Microbes are all over the place. I have steered away from certain braided none absorbable sutures now due to increase incidence of bacterial colonization.    Braids can hide bacteria better & also presents a barrier for antibiotics to get through.     Lateral ankle ligament reconstruction is not very difficult to do, most patients have enough of their own tissue nearby that can be rotated to reconstruct ligaments.

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