Massive Hemorrhagic Blisters following Bilateral Total Knee Replacement: A Case Report.

INTRODUCTION

Skin blisters occur due to increased shear forces at the dermo-epidermal junction. They are classified as clear and hemorrhagic blisters. Blisters occur due to trauma, compartment syndrome, and vascular deficits. We present a case report of hemorrhagic blister formation following bilateral total knee replacement.

CASE REPORT

A 64-year-old male with bilateral advanced osteoarthritis of the knees underwent bilateral total knee replacement in the same sitting. Surgery was done under strict aseptic precautions and tourniquet control. The procedure went uneventfully. Postoperatively, on the 2nd day, the patient developed massive hemorrhagic blisters around the operated site in both legs. Doppler scans showed no evidence of deep vein thrombosis. The blisters were managed by intravenous antibiotic coverage and soft, non-adherent collagen dressings. The blisters healed and reepithelialized by 3 weeks. A range of motion exercise was initiated on the 2nd post-operative day, as tolerated. At the final follow-up of 1 year, the patient had satisfactory Oxford Knee Scores.

CONCLUSION

Non-adhesive dressings, prophylactic intravenous antibiotics, and effective rehabilitation are the keystones in the management of patients with hemorrhagic blisters following total knee replacement.