Is there a pro of Woundcare Around?

[PsychoJane]

Ok... I'm a bit fed up right now....

I had surgery on may 8th... a laparotomy procedure. It got "abscessed" without being infected. The incision was like 14cm long and there was 14 staples. They removed 3 of them to allow the liquid to get out and they filled the dehiscence with basic wick dressing in hope that the cavity up and down the incision would fill up and then they could remove the other staples a little later. Well... it was going well till the staples started falling from themselves as they aren't suppose to remain there forever. That being said... the dehiscence is now bigger than it was at stage one since the sinus never filled up... Anyway... maybe all was I wrote sound common to someone who got the same type of issues.

Other than being desperate as it seems like it will never end healing... yes I know it will but gosh... since we took the staple off yesterday... I'm back to where I was when it got infected and now it hurts on top so I feel like it's the never ending story... It suppose to heal bottom-up.... Anyway, I am now stucked in a "dressing dilemma"... Can anyone tell me what type of dressing they had?

Was it adsorbant wick plus dry dressing? Was it some aquacell + additionnal dressing? Was their something filling the cavity (mine is not insanely deep... just enough so it drains like a mofo and I need to spend my life at the local health place to get them changed....)? Were they putting some sort of gel? Or was it more like a foam pad that they would fit in your wound?

Any ideas, experiences, comments will be appreciated... I should have done my Nursing... Everything would seem more simple as of today...

 

[afidz]

I have had a few non healing wounds in the last 2 years. My doc ordered a wound vac, its basically a sponge attached to a hose that sucks the fluid out 24/7, the sucking encourages new cell growth allowing for it to heal from the bottom up like you mentioned. the vac doesn't hurt itself but getting the dressing changed is very painful ( i have no feeling left in my abdomen so the last time it didn't hurt at all) I would talk to your doctor about it, your wound may not be deep enough for it or it ight not be the right option but its worth asking about

 

[PsychoJane]

Well well well, apparently, I'll need that VAC thing to get my wound healed at some point. The nurse I saw today (without me bringing it up) said I was an ideal candidate for the VAC pump and she was wondering why I was not on that yet or why the surgeon had not called for it. Well... the wound has evolved not in the greatest way in the past 2 days so it's kinda getting worst. Anyway... Monday will be the Ostomy/Wound nurse - Surgeon hunt in order to find someone to prescribe me this or something appropriate to get that incision under control. I hope I'll find something as it's seriously getting painful. Geez, it's worse than it was the first post-op days. I guess the nerves are all growing back and are now sored because it broke apart again. =[ Hopefully it will heal withing 2-3 weeks as she seems to say.

Afidz, can you tell me at what frequency they were changing your foam thing? The nurse told me something today and I want to see what is the tendancy as she seems to say it differs according to the case.?

 

[afidz]

I had to have at home health care, so the nurse came out monday wednesday and fridays to change it. So when I had to go to the dr, I would schedule my appointments on one of those days before the nurse came out so that the dr could take it off and then it would be put back on later that day by the nurse. The vac is very overwhelming in the beginning because its adjusting to a new lifestyle. But after the first week or so it will be considered your new norm. I hope it all works out for you and if you have any questions about my expierience with it feel free to let me know!

 

[PsychoJane]

Thank you! I guess I might have some question in the near future....
Just wondering, is that thing noisy?

 

[KWalker]

I was supposed to have the vac also but couldn't because of the location of my abscess. I was told they would change it every 3 days, but it needs to stay 100% dry or else it will come loose and you won't be getting that vacuum anymore. I wasn't exactly disappointed that I couldn't use it though as I was told you need to carry that box with you at all times and they told me it weighs about 10 lbs and is bulky. They told me that when they first turn it on after being changed that it can be uncomfortable and feel overwhelming but after a minute or two it goes away and you don't feel it "sucking".

On the plus side though, it is said to heal much faster and effectively. Because of the fact it needs to stay completely covered there is also less chance of it getting infected or anything like that. All and all, the biggest turn off for me was the size/weight of the box itdelf and I didn't want it being seen or annoying for me.


The first time I had my abscess they used silvercel which I strongly suggest against using, and the second time it was just a packing to keep the top open to allow the inside to heal first. They also used an intrasite gel to help as well.
They did that until it was shallow enough that the packing wouldn't stay in. Its been six months now and although it doesn't require packing, it still leaks (some days more than other) but it doesn't bother me at all. I ride my bike 10km a day with no problems, etc. Its a slow process but the vac packing should speed it up a bit for you.

 

[PsychoJane]

Mannnn I'm so annoyed by surgery world at the moment it's not even funny. So I went to get the dressing changed today. The nurse that saw me yesterday found that the wound was getting worse, ie. increasing in size and weeping more. She figured that we would be better off trying to contact my surgeon to figure out if we would be better with some more appropriate dressing and/or the VAC. So... I went to the emergency, waiting to see my surgeon. Just before I get there, they had an emergency (and I really don't care if I wait since I really prefer them saving someone that taking care of my wound, you know priorities are priorities!). That being said I ended up waiting 4 hours which is fine enough to see the extern and the junior resident who randomly told me they were told that I would probably be hospitalized. My reaction was: WTF! why so?. Later on, they sent the senior resident that almost laughed at my situation as my wound to him seems pretty basic (I am so sorry that having a deep hole opened in my belly does not seem as normal as it seems to you!!!) Anyway... I'm just mad I did not see my surgeon, that the resident almost laughed at the VAC idea and told me to keep getting my dressing changed often and that it would end up healing eventually. Thank you... for making me wait and almost laugh at my situation... I guess they just don't all get their diploma for their incredible sense of empathy...

Sorry for my rant... I'm just a bit mad atm as I feel like I'm back where I was with nothing else to help me heal faster.

Has anyone told you that your healing process (without the consideration of the meds you take) was impaired due to the fact you have Crohn disease? They somewhat forgot to mention that it was really common to split wide open after surgery for crohnies... (Thank's for telling me that after...! )

@Kwalker: why do you have something against the silvercell??

 

[afidz]

If the nurse doesn't do a good job putting the dressing on and making sure it is completly sealed it can be very noisy. I always made the nurse re do it if it was loud becuase I am the one that has to deal with that noise for the next 2 days. I am sorry to hear about your er visit. I wouldn't loose hope. I would call back your surgeon tomorrow and try to keep your cool. Because Crohn's is Auto immune your wounds are automatically going to be slow healing. Eat alot of protein and if you smoke, quit. I am about to go in for my 15th surgery in the next couple of weeks and I am scared that I am going to get another non healing wound. They aren't easy to cope with. best of luck. either send me a private question or ask on this thread, I will try to come back to this thread regulary

 

[GutlessWonder86]

I'm dealing with a non healing wound myself. The darn thing reopened 2 weeks ago and I've been dealing with it since last year. I had a wound vac which was great and healed it within 4 weeks. Now my MD doesn't know what to do with me so he's referred me to a plastic surgeon. So sick of hospitals and I told the doctor NO MORE hospitalizations unless it's life or death for me as the most recent experience I had was bad.

I wish I knew what was causing the wound to dehyst as I don't have an infection, I don't do any heavy lifting, and I've been very compliant when it comes to taking my medications and eating healthy. Good luck to you.

 

[KWalker]

Jane, the reason I don't like the silvercel is because that's what caused my second surgery. It has silver in it and the purpose of it is that when the piece touches the infection, it helps kill the infection. I was also told it is extremely important to use a jelly to help protect the good tissue. Well my nurses didn't use the gel and they couldn't ever seem to push the packing in far enough so instead of healing, it ended up damaging the good tissue and causing the infection to spread. That's why I had my second surgery 3 weeks later. My original incision was only 1-2 inches I believe, and after the second surgery there were now two long incisions and the longest was 7 inches. Quite a difference eh?

I know my experience after that would make me bias in not wanting it but it really bothered me that due to the nurses mistakes it made things worse.

 

[PsychoJane]

@Afidz: I really hope you get the very best surgeon ever this time and that their won't be any complications before/during/after and everything will heal perfectly fine! Do you know if they could plan using a VAC directly in order to avoid the wound dehiscing by itself later on in the healing process? I've read some stuff about that where they just use it in a preventive manner to make it heal properly that way right at the start?

@GtLWs: Seriously... reopening after a year, it must be pretty upsetting to get that happening =[ I'm sorry you are dealing with that again. Hopefully the plastic surgeon will find a way to make the tissues heal properly so you won't have to deal with that for too long. Some of them are magicians!

@Kwalker: Aye Aye aye. I so hate what I call "human" mistakes. It is so upsetting to know that something wrong has been done and when something right could have been done. I mean, sucks to know we did not know. I guess we should all be doctors/nurses to be able to watch over ourselves... I've seen so many mistake happening on my case that I barely trust anyone or anything which makes everything more difficult when it comes to take care of my health or being hospitalized or what not. I know for a fact that certain type of dressing can be appropriate or not and that lots of people (in the medical field) don't really know how to use them themselves. I spent the last week trying to figure what I should/ should not be using for my wound... You would think someone in convalescence should not have to find it's own treatment/care plan... I can understand how upsetting it was to have your wound get worsen due to misuse of the dressing... Seems like it could totally have been avoid...

 

[KWalker]

Oh it definately could have been avoided. I had a surgeon everyone would want to have so when she sent me home she made a specific list of things I needed, and a list of what the home care nurses are expected to do, etc. I had 4 huge boxes of supplies sitting in my house for when the nurses come so they didn't need anything. When I has in the hospital the second time the surgeon was explaining the packing when it clicked in and I was like "umm, they didn't use any gel when they were packing me". Turns out I had a ton of brand new tubes of gel sitting at home in the box waiting to be used. My surgeon was NOT happy and made a pretty funny (for me) phone call to the homecare office and demanded different nurses for when I got sent home the second time. (In my city, nurses get determined by area so if you have them once, you'll have them again)