Therapeutic rationale for saline bag stapled to pt's leg?!?

Nurses General Nursing

Published

A few weeks ago I had a young patient admitted for an infected upper thigh wound which occurred after the patient had jumped over a fence and cut himself. The injury was quite serious and required a skin graft that was placed at an outside hospital. After the graft was placed, the physician cut up a saline bag (just like the ones we used to administer a regular old 1 L bag of 0.9NS)and stapled it to the patients leg! No other dressing, just the stapled plastic bag. The patient later left AMA and came to our facility for further management. There must have been some therapeutic reason for stapling the bag to the patient's leg (Maybe for the wound to retain moisture to heal?) but it looked inhumane and like some crazy hackjob! Any thoughts fellow nurses?

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Specializes in Neuro ICU and Med Surg.

Um.....No that is not right. I cannot fathom cutting up a bag of 0.9 NS and seeing someone stapling it to the leg. My dad had a skin graft about 17 years ago and he had the graft site covered by something called a bio sheet. It was stapled in place, but it was to prevent infection. It was medicated with some kind of antibiotic I believe.

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This sounds really strange! I've seen a pediatric urine collection pouch (can't think of the proper term) over a small weeping area of skin. I've also seen something similar to what the other poster mentioned. Again, can't think off the proper term, but it looked like a sheet of clear plastic like substance stapled along the site.

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Are you sure the patient was telling the truth?

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With the other multitude of options available for the integrity of someone's graft, with coverings that are just as thick as the plastic used for containing IV fluid, I can't imagine why this would be done by any MD.

Can you get the records from the former hospital?

Perhaps this patient was freaked out about the graft, and decided to "cover" it himself? And when it was discovered left AMA? Are you also sure that this is not some sort of covering that just has lettering on it similar to an IV bag? Not sure why this would be stapled to skin, however....

Very strange indeed. How in the world did you get it all off without taking the grafted skin off with it?

Poor patient. Very sad. How has this resolved itself now?

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Specializes in LTC,Hospice/palliative care,acute care.

If it is true that the physician actually did this I would have to wonder if he is having cognitive issues or a drug problem.

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Specializes in Critical care.

I've seen it done to cover open abds between multiple trips to the OR. It's occlusive, tough and can withstand spirited patient activity.

Regular op-sites can be lifted off/dislodged by a curious pt and can't hold up to being stapled.

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Specializes in PDN; Burn; Phone triage.

Are you sure this isn't telfa or some variant?

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Specializes in Surgical, quality,management.

I've seen a finger of a glove used instead of a Seton drain so it is possible. Surgeons who have worked in the developing world or in war zones are very innovative

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

When they have to stop a CABG surgery and bring the patient back to the ICU with the chest still open to be stabilized they come with cup open bags of saline covering their open chests. Is a common practice.

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Specializes in Critical Care.

I've seen this done for surgical wounds as well as for weeping edema (without the staples). It works particularly well for weeping edema since the tubing port can used as a drain port.

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It was definitely a saline bag, I could tell

By the lettering. A surgeon came and removed the staples and the bag and the patient was discharged several days later. The attending at the time did not seem half as alarmed as I was which made me think there had to be a reason for it.

I suppose the pt could have done it himself but I have no idea where he could have gotten the supplies. He also seemed like a pretty 'normal' person for lack of a better word. Very grateful, compliant and realistic.

I hope to never see something like that again. Looked careless, painful and inhumane

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