Osteomyelitis and a sinus tract

The skin opening may be small even when the channel extends deeper. Fluid can be clear, cloudy, bloody, or foul-smelling, and the drainage may stop and return. A tract can develop after an open fracture, surgery, an implant, or a long-standing wound. The surrounding skin may be tender or thickened, but the absence of fever does not rule out a deeper infection. A swab from the surface may not represent what is inside the bone, so clinicians decide whether deeper sampling or imaging is needed.

Cover the opening with a clean dressing, wash your hands before and after changing it, and record changes in colour, smell, amount, pain, or redness. Do not squeeze the tract, probe it, seal it shut, or pour antiseptic into it. Keep appointments even if drainage temporarily decreases. Tell the clinician about implants, previous antibiotics, operations, and any change in your ability to walk or use the limb.

Seek prompt assessment for a new or persistent draining opening over painful bone. Get urgent help if redness spreads, swelling increases, drainage becomes heavy, fever or chills appear, or you feel weak, confused, or faint. Sudden severe pain or loss of limb function also warrants urgent review.

Ask how deep the tract appears, whether imaging can map it, and whether a deep sample is appropriate. Clarify dressing care, activity limits, warning signs, and how an implant or dead bone would affect management.