When I last wrote, I mentioned that I had developed a second infection of my surgical incision which we discovered on 8/26. My surgeon changed the treatment plan from a wound vacuum to using a twice daily wet-dry dressing and changing it twice a day.
Regardless of the dressing and treatment used on the wound. Each dressing change starts by cleaning the wound with sterile saline and gauze sponges. The wound nurses swabbed the wound and ensured that all exudate and loose tissue was sponged off the wound. They then blotted the area dry in preparation for the application of the dressing.
Wound Vacuum (aka negative pressure therapy)
This consists of a porous material which fills the wound. An air-tight sealing tape fastened a suction device to the porous material (in my case an open-celled foam) and the surrounding skin. This allowed a machine to provide suction to the wound and extract any wound exudate/drainage.
Until 8/25, the quantity of drainage extracted by the wound pump from my wound was small. Over the evening of 8/25 through 8/26 the wound pump extracted the equivalent of a weeks worth of wound exudate. On the morning of 8/26, the drainage had turned milky or tan in color (purulent exudate) which strongly indicated the wound was infected again.
Wet-Dry Dressing
The dressing consists of gauze (they usually use 1-2 4x4 gauze pads on my wound) moistened with sterile saline solution applied directly to the wound. They cover the wound and "wet" gauze with a sterile dry dressing (they use ABD pads on my wound - I assume "ABD" stands for "abdominal").
The principal is that the moistened gauze will wick any wound exudate/drainage out of the wound and into the dry ABD pad. In my case, the exudate from 8/26 looked like purulent (likely an infection), that of 8/27 appeared seropurulent type (suggests an infection), while later it appeared of the serous type (indicates normal wound healing).
Surgeon's Visit
Because my wound's symptoms strongly suggested that I had developed another surgical infection, my surgeon scheduled me to visit on 8/29. Because of the possible seriousness of the second wound infection, my surgeon instructed me to prepare for out-patient surgery. This meant that I stopped taking anything by mouth (PRN) after midnight on Thursday in preparation for general anesthesia/sedation and to ensure that I had someone to drive me home. As of Wednesday of this week and due to the condition of the wound, I convinced myself that I was going to get minor surgery.
Luckily for me, the signs of infection in the wound cleared up and by the time I visited my surgeon, the wound looked healthy again.
During this visit he declared that I was promoted to a "full" diet - meaning I can eat anything that I want :) He also noticed some unhealthy tissue (left over from the infection?) and elected to "debride" my surgical wound.
Wound Debridement
The purpose of wound debridement is to remove unhealthy, necrotic (dead), and/or infected tissue so that only healthy tissue remains. In most cases, this significantly increases the rate of healing. There are many methods of removing this tissue. In my case, the surgeon mechanically scraped the tissue out of the wound using the back-end of a surgical applicator (it looks like a q-tip with cotton swab on the front-side and a wooden stick on the back-side).
The process took several minutes and the surgeon asked my wife to watch (did he want her to do this to me later in the healing process?). He scraped the tissue until he removed all of the unhealthy tissue and induced minor bleeding.
In my case, I kept my eyes shut through the process. The reason for this: I had no pain medication from midnight the night before the procedure (over 9 hours), so I was already in moderate pain (about 4-5 on my pain scale). The debridement process, in my case, was uncomfortable but did not induce lots of extra pain. However, when the process was complete and I was able to take some pain medication, I did so as soon as possible :)
A day later the whole area still feels a little raw and is somewhat more painful.
All in all, my recovery from this surgery continues at a pace much faster than my previous surgery. Three weeks after the surgery my mobility, pain, and flexibility are all very much better than they had been after that surgery.
Regardless of the dressing and treatment used on the wound. Each dressing change starts by cleaning the wound with sterile saline and gauze sponges. The wound nurses swabbed the wound and ensured that all exudate and loose tissue was sponged off the wound. They then blotted the area dry in preparation for the application of the dressing.
Wound Vacuum (aka negative pressure therapy)
This consists of a porous material which fills the wound. An air-tight sealing tape fastened a suction device to the porous material (in my case an open-celled foam) and the surrounding skin. This allowed a machine to provide suction to the wound and extract any wound exudate/drainage.
Until 8/25, the quantity of drainage extracted by the wound pump from my wound was small. Over the evening of 8/25 through 8/26 the wound pump extracted the equivalent of a weeks worth of wound exudate. On the morning of 8/26, the drainage had turned milky or tan in color (purulent exudate) which strongly indicated the wound was infected again.
Wet-Dry Dressing
The dressing consists of gauze (they usually use 1-2 4x4 gauze pads on my wound) moistened with sterile saline solution applied directly to the wound. They cover the wound and "wet" gauze with a sterile dry dressing (they use ABD pads on my wound - I assume "ABD" stands for "abdominal").
The principal is that the moistened gauze will wick any wound exudate/drainage out of the wound and into the dry ABD pad. In my case, the exudate from 8/26 looked like purulent (likely an infection), that of 8/27 appeared seropurulent type (suggests an infection), while later it appeared of the serous type (indicates normal wound healing).
Surgeon's Visit
Because my wound's symptoms strongly suggested that I had developed another surgical infection, my surgeon scheduled me to visit on 8/29. Because of the possible seriousness of the second wound infection, my surgeon instructed me to prepare for out-patient surgery. This meant that I stopped taking anything by mouth (PRN) after midnight on Thursday in preparation for general anesthesia/sedation and to ensure that I had someone to drive me home. As of Wednesday of this week and due to the condition of the wound, I convinced myself that I was going to get minor surgery.
Luckily for me, the signs of infection in the wound cleared up and by the time I visited my surgeon, the wound looked healthy again.
During this visit he declared that I was promoted to a "full" diet - meaning I can eat anything that I want :) He also noticed some unhealthy tissue (left over from the infection?) and elected to "debride" my surgical wound.
Wound Debridement
The purpose of wound debridement is to remove unhealthy, necrotic (dead), and/or infected tissue so that only healthy tissue remains. In most cases, this significantly increases the rate of healing. There are many methods of removing this tissue. In my case, the surgeon mechanically scraped the tissue out of the wound using the back-end of a surgical applicator (it looks like a q-tip with cotton swab on the front-side and a wooden stick on the back-side).
The process took several minutes and the surgeon asked my wife to watch (did he want her to do this to me later in the healing process?). He scraped the tissue until he removed all of the unhealthy tissue and induced minor bleeding.
In my case, I kept my eyes shut through the process. The reason for this: I had no pain medication from midnight the night before the procedure (over 9 hours), so I was already in moderate pain (about 4-5 on my pain scale). The debridement process, in my case, was uncomfortable but did not induce lots of extra pain. However, when the process was complete and I was able to take some pain medication, I did so as soon as possible :)
A day later the whole area still feels a little raw and is somewhat more painful.
All in all, my recovery from this surgery continues at a pace much faster than my previous surgery. Three weeks after the surgery my mobility, pain, and flexibility are all very much better than they had been after that surgery.
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