Highlights
Introduction
Dominic Harvey, is a 54 year old male who has worked in construction since he was 15.
• Dominic was admitted for a compound # tibia/fibula L) leg at a workplace accident 6 days ago. Surgery was done to repair.
• A plate and screws were used to stabilise the injury as part of the procedure. Antibiotics were given by the anaesthetist on anaesthetic induction. He had an uneventful post-operative period and was discharged three days later. Dominic was discharged with non-steroidal anti-inflammatory medication for pain relief for 7 days, and opiates for 24 hours, non-weight bearing on crutches, he has an appointment for review with surgeon in 2 weeks.
Situation
Early this evening Dominic re-presented at the ED. Complaining of pain at incision site, nausea and feeling shaky/shivery. Wound site left knee, sutured, skin appears ‘tight’, shiny and red. There are several small areas were dehiscence is evident with pus present. Oxygen therapy has been commenced.
Background
• PMH: Osteoarthritis, asthma since childhood, tonsillectomy aged 11, #L) wrist age 16, height 168cm, weight: 104kg.
• Drugs: NSAIDS, Ventolin, Seretide accuhaler
• Allergies: Tartrazine (yellow food colouring), cats.
• Social: Dominic is a non-smoker and swims regularly (3-4 times a week), he occasionally participates in squash and tennis with some work friends. He drinks 2-3 units/day on weekends only, he has 5 alcohol free days/week. He has a partner, 52-year-old, Boris Gordon who lives near Dominic and they see each other each day
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