After removal we put some Band-aids. Of note, X-ray AP and lateral of the patient’s left knee demonstrates he has a rotating hinge well seated and well fixed. Final diagnosis is post revision of the left knee with subsequently large hematoma which got infected. The provider notes that the INR is back to appropriate level, 2.8. The patient is on Coumadin only and off of the Lovenox which cause a lot of problems and severe bleeding post-operatively. The patient is on a dose of Clindamycin 600 mg twice a day which he is going to be on for probably the rest of his life. He is going to take that along with his Coumadin. His wound is fortunately completely close. Sutures are all out. So, at this point, my plan is just going to maintain him on the low dose of antibiotics because the only other choice is take the entire prosthesis out and put a spacer in, and have an IV antibiotics and then re-insert. It was further notes that because the patient is on substantial blood thinners because of the cardia valve, he bleeds and when he does bleed especially around the knee, the pocket of blood with lead to an infection. The provider also notes that the patient needs an extension of physical
After removal we put some Band-aids. Of note, X-ray AP and lateral of the patient’s left knee demonstrates he has a rotating hinge well seated and well fixed. Final diagnosis is post revision of the left knee with subsequently large hematoma which got infected. The provider notes that the INR is back to appropriate level, 2.8. The patient is on Coumadin only and off of the Lovenox which cause a lot of problems and severe bleeding post-operatively. The patient is on a dose of Clindamycin 600 mg twice a day which he is going to be on for probably the rest of his life. He is going to take that along with his Coumadin. His wound is fortunately completely close. Sutures are all out. So, at this point, my plan is just going to maintain him on the low dose of antibiotics because the only other choice is take the entire prosthesis out and put a spacer in, and have an IV antibiotics and then re-insert. It was further notes that because the patient is on substantial blood thinners because of the cardia valve, he bleeds and when he does bleed especially around the knee, the pocket of blood with lead to an infection. The provider also notes that the patient needs an extension of physical