Necrosis after cast removal

I am so sorry this is happening. I had ankle surgery (trimalleoral and ORIF) and had two different incisions as well. The day I was supposed to be discharged, my doctor saw my foot had a strange color he didn't like (side note: this happened in Korea and they still don't allow people from outside due to COVID, my Korean isn't great so I think he may have avoided big words like necrosis or infection). He told me he did not feel comfortable sending me home, that if I did, he'd want me back every couple days to continue checking on the color. I decided to stay and I was on very strong antibiotics for a week and a half, then sent home with more antibiotics. I was told that, because of the color, I would not be using a caste but continue with the boot and the splint so I could check it daily.

I am not sure if it was necrosis (I did check pictures at the time and thought it was the beginning of it), but it felt hot and painful to touch, and the color was very red. I also had to sleep in a boot and, in my case, it wasn't painful (only the first days post surgery but I assume that's unrelated to the infection).

The doctor had me going back to check on my blood tests to see if there was any strange inflammation in my blood and out visits were weekly until he said "it looks normal, I'm not concerned anymore." I was also told in the meanwhile that, if something started to look red, I had to call the hospital in the emergency line ASAP and they'd check and give me antibiotics, maybe put me in the hospital again.

So, again, I was never told what it was and it may have been because my Korean isn't the best, but the doctor was clearly concerned. In fact, I had this nurse guy checking my bandages post-op and he didn't note anything about my foot, the doc screamed at him and, from then on, I had the doctor changing the bandages himself every day. He'd also come every night to check. So, not sure how useful my experience is since I only had antibiotics (pills and in IVs) and monitored constantly after they noticed the color, but that's how my doctor dealt with what seemed to be the start of something...

Best of luck! Sending you all my good wishes. Don't think about how long it will take to start walking, just healing.

Thanks for your nice reply and I'm sending you good healing wishes as well. In case any one else is following this and dealing with something similar, here is where I am. Fortunately the pain was only the night after cast removal and I have been able to stay in a boot since then. Cast was removed nearly 4 weeks ago and I've been told it will be another 3 weeks at least for wound to close. I did Iodsorb topically on it daily for the first 2 weeks after cast removal until it was debrided for first time by wound clinic, and was then instructed to do a daily cleaning and acetic acid dressing packing inside the hole (2 centimeters deep) for the next month. I ended up having to go back the week after the first debridement to get it debrided again and packed in the office with Betadine dressing. I was surprised they could not let me come in to have this done properly at wound clinic at hospital (told me due to nursing shortage) and I was told I was ineligible for a nurse to come to my home since I already started PT. I have been completely unable to push anything into the hole and now I cannot tell if it is closing up healthy as it should, or if it is closing up not in a good way. At least I can send photos to the wound clinic as I go along. Very tough not to be walking 3 months post-surgery and having to deal with this complication. Just putting some weight on foot past week, still on crutches.