I've known people with discitis... that is very rare, but very severe. I've not seen it in disc replacement patients... the people I've known with serious infection problems were
discitis --> osteomyelitis (infection of adjacent vertebral bodies) from endoscopic discectomy... not from any of the docs I work with.
MRSA - severe deep wound infection associated with lumbar fusion / revisions. I've also seen deep wound infections associated with other abdominal surgery. I've seen people hospitalized for this... they get PICC lines for IV antibiotics... I've seen people who spend weeks in the hospital with the big abdominal wound open for healing... very nasty stuff.
I hope some of the nurses will come along and address some of Rob's questions. I do believe that running a substantial temp for a length of time can be an indicator and such a symptom should be presented to your doc. I have also seen many people who run low-grade temps after surgery without concern on the docs part. I think that staying on top of the situation and running the appropriate labs keeps things in check.
I've seen some people who's wounds don't heal as fast as others. Some are sealed up right away... some ooze for many days or longer. Again, you should check with your doc to know when to be concerned. I believe that the subcutaneous fat tissue necrosis is not uncommon and usually resolves itself without the patient even knowing that it occurred. (These may be the folks with more slowly healing wounds.) Also, many will have a seroma, or an accumulation of clear fluid after surgery, especially abdominal surgery. Many will have seroma and never know it. Seroma in conjunction with a small topical infection or the fat tissue necrosis may create a confluence of problems that my generate more weeping of a wound.
Infection rates may vary greatly from one facility to another, or from one surgeon to another. Fortunately, patients of good surgeons working in good facilities enjoy very, very low infection rates. I believe that a post-op infection can be serious and therefore should be worked up and treated quickly. People with infections that aren't taken seriously can wind up in much worse shape than if they had gotten early, appropriate treatment.
Small infections of incision sites are not uncommon and are easily treated, but the big 'deep wound' infection is a very serious complication. I wish we had easy access to numbers for infection rates in US hospitals. I believe that we'd find that most are excellent, but some facilities should be avoided.
As aways... the "I'm not a doctor" disclaimer applies here. I'm just sharing my impressions from my experience. I hope that someone with much more knowledge than me will come along and post. Maybe some internet miner can dig up some study data. (Although I take study data with a grain of salt.)
All the best,
Mark
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