Compartment and infection thresholds
Pain out of proportion, pain on passive stretch, paraesthesia, a tight cast, or a wound with spreading redness, discharge and fever. Any of these ends the contact and routes to the surgical team immediately.
Specialty · Orthopedics
Post-operative recovery, watched between appointments.
Joint replacement and fracture follow-up, physiotherapy adherence, wound and VTE surveillance, and pre-operative preparation — with compartment syndrome and infection thresholds on every contact.
- 89%
- Post-operative checks completed
- 44%
- Better physiotherapy adherence at 6 weeks
- < 60s
- Compartment symptoms to escalation
In the product
Ortho follow-up — TKR day 5
EscalatingOutbound 10:15 · Peter M. · 68 · right total knee replacement · day 5
Primum
How does the wound look today compared with yesterday?
Caller
Redder, I'd say, and it's leaking a bit onto the dressing. I felt hot last night.
Primum
I'm sending a link now — take one photo straight on from about 30cm in good light.
Image received 10:19 · erythema extending > 2cm from incision · serous discharge
Erythema + discharge + subjective fever → surgical site infection criteria met
Primum
I'm arranging for the surgical team to see you today. Don't start any antibiotics you have at home before they've looked at it.
Wound assessment
- Procedure
- Right TKR · day 5
- Erythema
- > 2cm from incision
- Discharge
- Serous, dressing stained
- Systemic
- Subjective fever overnight
- Image
- 1 · usable
- Routed
- Surgical team, today
Reviewed by registrar 10:24 · same-day slot confirmed · image in chart
Overview
The operation is one day. The recovery is fourteen weeks.
- Structured contact at the intervals your pathway sets, not just at the clinic date.
- Wound images and swelling checks with infection and VTE thresholds applied.
- Pre-operative optimisation completed before the patient reaches the admissions desk.
Orthopedic outcomes are made after the patient goes home: whether the exercises get done, whether the wound is watched, whether a swollen calf is reported or ignored, whether the pain is being managed well enough for anybody to move. The clinic sees the patient at six weeks and finds out what happened.
Primum makes contact through that whole period — wound checks with photographs, range-of-movement progress, physiotherapy adherence, analgesia adequacy, VTE symptoms — and escalates against your own thresholds. Before surgery it runs the optimisation checklist that decides whether the operation goes ahead at all.
Capabilities
What the fourteen weeks actually require
Four areas, one of which is a surgical emergency.
Wound review with images
Photographs collected with framing and lighting guidance at the intervals your pathway sets, assessed alongside systemic symptoms rather than on appearance alone.
Physiotherapy that gets done
Adherence, range of movement, weight-bearing status and whether pain is the barrier. Patients falling behind at two weeks are the ones who need a physiotherapist at four, and this finds them.
Pre-operative optimisation
Anticoagulation, diabetes control, anaemia, smoking, MRSA screening, fasting and escort arrangements completed ahead of admission rather than discovered on the morning.
How it works
Discharge to discharged
Contact at the points where the pathway says something can go wrong.
- Arrives
- Decided
- Done
- Returned
01
Procedure registered
Operation, weight-bearing status, thromboprophylaxis, wound closure and the rehabilitation protocol loaded, with the contact schedule set from them.
Pathway loaded
02
Recovery tracked
Wound images, swelling, range of movement, analgesia adequacy and exercise adherence captured at each scheduled contact.
Staged contacts
03
Thresholds applied
Compartment syndrome, surgical site infection and VTE criteria evaluated on every contact before anything else is considered.
Surgical red flags
04
Escalated or progressed
Surgical team alerted, or the rehabilitation stage advanced, the record updated and the next contact scheduled.
Team alert / write-back
01
Procedure registered
Operation, weight-bearing status, thromboprophylaxis, wound closure and the rehabilitation protocol loaded, with the contact schedule set from them.
Pathway loaded
02
Recovery tracked
Wound images, swelling, range of movement, analgesia adequacy and exercise adherence captured at each scheduled contact.
Staged contacts
03
Thresholds applied
Compartment syndrome, surgical site infection and VTE criteria evaluated on every contact before anything else is considered.
Surgical red flags
04
Escalated or progressed
Surgical team alerted, or the rehabilitation stage advanced, the record updated and the next contact scheduled.
Team alert / write-back
Benefits
Complications found early, clinics used well
Both come from the same structured contact.
Infection is caught at day five
A wound reviewed with an image and systemic symptoms at the right interval is caught before it becomes a washout.
Function at six weeks improves
Adherence in the first fortnight predicts range of movement at three months. Contact in that window is where the outcome is made.
Routine reviews stop filling clinics
Patients progressing normally are reviewed by phone, which returns clinic slots to the ones who are not.
In practice
Four post-operative contacts
One of them is a surgical emergency.
Tibial fracture, day 1 in cast
Escalated in 45sPain increasing despite analgesia with pins and needles in the toes. Compartment syndrome pathway opens and the on-call orthopedic registrar is paged.
Knee replacement, day 5
Infection reviewWound image shows spreading erythema with a low-grade fever. Reviewed the same day rather than at the six-week clinic.
Hip replacement, week 2
Physio escalatedExercises abandoned because of pain. Analgesia reviewed and a physiotherapy contact brought forward.
Calf swelling, day 9
VTE pathwayUnilateral swelling and calf pain post-operatively. Assessment arranged the same day with the operation date attached.
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Follow one joint list for six weeks
Give us a single arthroplasty list. We will run the full contact schedule and hand you what was found, when it was found, and what reached a surgeon before the six-week clinic.