Sunday, July 12, 2009

Immediate Post Surgery Wound Care Hints


By Amy Price PhD

After surgery wound care could be better addressed. The advice is usually to ice the area for twenty minutes at a time and don't get it wet for 48 hours to 21 days depending on the procedure because of infection risks. Who are they kidding...After bleeding, being washed down with iodine and being touched,probed,cut and stitched by hands I have no personal relationship with all that I want is a bath or a shower!

The risk of infection is serious as it can travel to your bones or become systemic and cause more damage than the original problem. It can travel through open places in the wound or through the stitching which acts as a wick. Until the area has healed over it is best not to swim or use a hot tub because of bacterial risks. It is important to follow your doctor's advice for changing dressings etc. If the area becomes hot to the touch, swells rapidly,starts pulsing or you start to run a fever get your doctor's advice.

To shower after spine and cervical surgery I purchased a silicon swim cap as this is completely waterproof and less irritating than latex. I cut generous pieces which I placed over the wound and taped it in place with duct tape. For arms and legs I used umbrella bags, big ones for leg and smaller for arm areas. I placed them over top of the dressing and bandage and taped this in place. You will still need to exercise care and try not to get the area wet...a bath could be a bad idea! If it gets a little damp in spite of all precautions gently dry the area, put on topical antibiotic and replace the dressing.

If this was an emergency room visit remember emergency rooms will only stabilize you, they have no obligation to provide treatment beyond this. An emergency room visit needs follow up with a doctor. At emergency if you have tendons exposed insist on being seen by a specialist on call. I had three fingers all with tendon avulsions stitched up with no repairs. It took a year of occupational and physical therapy to get the function back. A word to the wise...if you have broken something and they have splinted, cast or wrapped it and it starts to smell bad or the exposed areas turn dark and lumpy go back to the hospital. They don't mean literally black, if it darkens substantially, swells and get worse rather than better have this checked out. With a temporary cast the swelling can cut off the circulation and the tissue starts to die. I almost lost a hand this way as I was told if it turns black come back, since it cost me 10,000 dollars for the emergency room appearance and 273 dollars for a bandage available at the dollar store.I really wasn't up for a repeat visit!

The ice is easy in principle but not so easy for the drugged and injured to apply. Some people travel for surgery and it is a considerable time before they are at home to ice. Do yourself a favor and buy some instant ice at a pharmacy before your procedure or get the surgery to supply you with a couple of extra packs for the trip home. The ice takes down swelling and eases pain while helping your body heal. At home consider the wound site. An awkward area like the elbow,knees or shoulders may be best with a bag of frozen peas which will bend to the shape. A posterior neck surgery may benefit from an emptied and refilled with water large soda bottle (don't freeze the soda it explodes). Ask a family member or friend to do ice duty day and night. If you are like me and don't want to ask anyone for anything consider that you can buy them a gift, take them to dinner or return the favor. It is an investment in your healing. Be nice to those who care enough to be available, they do not benefit from you getting an attitude because you feel bad that you need the help and being thankful can go along ways towards preserving relationships

There will be a follow up post on scar care soon. This information is for educational purposes only and does not constitute medical advice. That is your doctor's assignment.

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