Overly sensitive skin and weird bump following bunion surgery

by Jen
(San Francisco, CA)

I had bunion surgery on both feet approximately 8 weeks ago.. my left foot (where the bunion was near the big toe) is now doing just fine, but I'm having a problem with my right foot (where the bunion was near my little toe). It is extremely sensitive to the touch, is still slightly swollen, and it feels like there is a hard bump underneath part of the incision. It is so sensitive to the touch that if anything brushes against it, it's really really uncomfortable. I am not sure what to do about this.

A little history:
-We discovered after the surgery that I have an allergy to a chemical called mastisol which is apparently used to make steristrips stick to the incision site. So, after surgery, I had terrible blistering (HUGE GIGANTIC blisters) on both feet anywhere that the chemical had touched. So basically, I had big raw patches of skin probably two or three inches all around the incision sites on both feet after the surgeon cut away the blisters. I don't think it's particularly relevant to my current issue since the skin has now regrown, but wanted to give all the info.
-My stitches could not be removed until about 4 weeks after surgery due to the issues with the blistering.
-The dissolvable stitches seemed not to dissolve at all, and at 5 weeks after surgery, a huge long stitch, probably 5 inches long, festered up and came out of my right foot (which the surgeon pulled out himself) and then over that next week I was pulling small bits of stitches out of my left foot myself. Apparently dissolvable stitches do not dissolve in everyone.
-At 6 weeks after surgery, my right foot still looked festered and red, so the surgeon numbed my foot and used tweezers to dig around to see if there were any stitches floating around causing the problem. He found a couple of remnants but nothing terribly serious. He advised me to keep soaking my foot and see if anything else came out.
-It is now 8 weeks after surgery, and the skin on the area has healed, and it does not seem as red and festery like it did before. But it is incredibly sensitive, and there seems to be a hard lump underneath the skin just in that one spot where the long stitch pulled out of. The sensitivity makes it very difficult to walk properly, and I can't even tolerate wearing shoes. Even at night, I have to sleep with my foot sticking out of the covers because if the bedsheet brushes against it, it's just too uncomfortable. My Physical Therapist had initially advised trying to massage the area to get the nerves adjusted, but that is not helping.

Do you have any helpful insight as to how I should proceed? The only two things I can come up with are to either live with it, or go back to the surgeon and ask him if he can remove the lump and hope that this time the skin heals better? Or maybe there is something I am missing here. I would appreciate any insight you might have. I am also going to attach a pic here of how the foot looks currently.

Very best,
Jen

ANSWER

Hi Jen,

The best advice is to always go back to your surgeon for hands on care, but having said that let me offer some insight.
Any numbness you may be feeling is probably due more to the severing of some superficial nerves than anything else. This happens quite often in all types of surgery. In most cases sensitivity will return over time.
The lump that you mention under the incision may be what is known as an inclusion cyst. This will occur in incisions where there has been irritation for whatever reason; in your case probably a reaction to the suture. In spite of the long piece of suture removed, there may actually still be a very minute portion of suture sitting there and irritating the area.
Your surgeon could try injecting a small amount of cortisone into the painful area to see what happens. I should warn you that the injection may be painful.
In most cases if the incision continues to be sensitive say for another couple of months and does not resolve, then you might give some thought to having the whole incision excised and sewn back together, probably not using deep absorbable sutures but instead putting in more nylon superficial sutures (and not using steri-strips).

Marc Mitnick DPM

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