infection after robotic prostatectomy

Hi I am new to the site !

Has anyone experienced infections around the incisions after the surgery ; possible staph infections ?

 

I can relate to your problem as I went through the same thing, Staph Aureus, over the course of the last three months. I ended up taking a half dozen different antibiotics on and off for ten weeks, the last was for 32 days straight, as the infection kept returning. I needed to keep on top of the doctors in order to get them to believe that I truly had an infection as when you are on the drugs the drainage appears clear and thus the doctors think there is no infection. You need to keep on top of this and take your temperature with a good accurate thermometer. Sepsis, when the infection gets into the blood can happen quickly, within hours, and is a true life threatening emergency. I was also seeing an infectious disease doctor as well. I told the doctor that I wanted imaging tests to see the extent of the problem. Ultrasounds may help but a CT scan would be better.

If you want to read the entire saga I will relate it here. I had surgery on September 25, 2013 and the catheter was in for eight days. I was on Ciprofloxacin as a prophylaxis due to risk of infection from the catheter. On Saturday, three days after the surgery my temperature started to rise to 100.5 deg F and I had the chills. I called the doctor and was told to take more Tylenol and come to the ER if the temperature went above 101 deg F. As it never went above 101, I waited until Monday morning to see the surgeon. The large incision below my umbilical had opened, possible due to a hematoma below the incision. The wound was now three inches long by one inch wide by two inches deep and was leaking clear fluid. The surgeon said it was not infected but as the wound had opened it must be treated as a "dirty wound" and allowed to heal on it's own from the bottom up.

The healing took about ten weeks with a visiting nurse coming daily to check and dress the wound. As I continued to complain that I experienced pain near the wound and up and down temperature spikes, my antibiotics were changed several times. Three days after completing the latest 10 day course of antibiotics, my temperature started to rise and I felt pain near the wound. Upon pressing near the wound to see where the pain was coming from, a large amount of thick yellow fluid came out of the wound. The infectious disease doctor was now able to culture the fluid as I was not taking any antibiotics. They found that it was a Staph infection and changed my antibiotics again, to Levaquin and Doxycycline for 14 days.

about 12 days after completing the 14 day course of antibiotics, my temperature again rose and I felt pain near the wound. Another culture was performed and the same Staph was found and I was put on the same drugs for 32 days. I insisted that I wanted imaging to assess the problem. Two Ultrasounds were performed about two weeks apart that seemed to indicate both Cellulitis and an abscess with no drainable fluid, located near the wound site. The abscess appeared to have gotten larger on the second ultrasound. After completing the 32 day antibiotics I went for a CT scan that showed no signs of infection. The doctor has told me that I need to keep an eye out for a possible return of the infection for the next 6-8 weeks.

This was a very frustrating experience for my wife and I and hope your issue is resolved quicker than mine. Good Luck!

Did you take a prophylactic?

Thanks Prowler; I am just before getting another Dr. in the loop; Monday is my self imposed deadline for symptoms to be improved. I am on an antibiotic for10 days currently and that should show some affects by then.

I am just so hesitant about questioning my Dr.'s methods. I believe he is an excellent surgeon, but his follow up care has been lacking in my opinion.

Could someone educate me ? What is a prophylactic and what purpose does it serve?

I just had a CT scan to see if my infection has resolved and it turns out I have a large lymphocele as a result of the lymph node removals. Seems that the lymphocele was the item that was infected for a three month period and not the wound below my umbilical.

Tango, have your infections resolved themselves?

My issues have returned suddenly with a 103 deg F fever. Fluid drained from lymphocele contained Strep Viridans. Installed drain to remove abcess fluid from from lymphocele so levaquin antibiotic can reduce fever. Seven days in hospital with dozens of blood tests, CT scans and many IV antibiotics before sorting things out. Released from hospital with 102 deg F fever, drain and Levaquin for next 14 days. Still may require surgery after all quiets down to prevent another scary temperature spike chills and uncontrollable shakes from happening, out of the blue. Day before this happened, I was on a nine hour road trip into very remote area with little healthcare and cell phone coverage. I would have likely needed to be air-lifted somewhere.