What is the Gold Standard of Care for post op incisional care?

Nurses General Nursing

Published

Specializes in Trauma ICU,ER,ACLS/BLS instructor.

Looking for some feedback in this area. We have a rate increase in post op cardiac harvest site infections. High thigh wounds,close to peri area. Any standards out there ? I have looked on so many site and can not find what I am looking for. Evidence based practice would be great. Thanks in advance!

Christine

Specializes in Med-Surg/Peds/O.R./Legal/cardiology.

Have you checked the good 'ole Lippincott?

http://www.sts.org/sections/stsnationaldatabase/

There is a search function that brings up tons of articles. Maybe you can find something there.

Can clean with chloraprep every shift?

Good glucose control can really help reduce post op infections as well.

Specializes in Trauma ICU,ER,ACLS/BLS instructor.
Can clean with chloraprep every shift?

Good glucose control can really help reduce post op infections as well.

Actually the cloraprep people just left my office. They r going to send me what they have on it. Right now they say it has limitations with certain incisions. Thanks!

Specializes in Cardiac Telemetry, ED.

We do daily and PRN incision care with betadine swabs on the sapheonous, RAG, and midsternal incisions, which are all open to air after POD 2. I don't work for a few more days, but when I go back, maybe I can find out the source for our incision care protocols.

Specializes in Trauma ICU,ER,ACLS/BLS instructor.
We do daily and PRN incision care with betadine swabs on the sapheonous, RAG, and midsternal incisions, which are all open to air after POD 2. I don't work for a few more days, but when I go back, maybe I can find out the source for our incision care protocols.

Thanks for the reply. In my research and in speaking to IC people, betadine is now frowned on post op and really anytime. Unless it is let completely dry when used,it can actually become a medium for growth. It also inhibits healing in open wounds . I am learning somethng new each day. Thanks again!

Specializes in Cardiac Telemetry, ED.
Thanks for the reply. In my research and in speaking to IC people, betadine is now frowned on post op and really anytime. Unless it is let completely dry when used,it can actually become a medium for growth. It also inhibits healing in open wounds . I am learning somethng new each day. Thanks again!

I'd be curious to see the evidence. In a 2003 literature review in Wound Care, the author states that while there is some evidence that povidone-iodine may inhibit wound healing, the studies are inconsistent and more research is needed. There was no doubt about its efficacy in reducing the bacterial counts of both innately resistant bacteria and those capable of acquiring resistance, and that it is effective even as proteins inactivate it.

Specializes in Cardiac Telemetry, ED.

Here's another article:

http://www.woundsresearch.com/article/1586

Specializes in Post Anesthesia.

We had the same problem with our post op CABG patients. Tried a number of different protocals to improve our stats without sucess. The solution was "Dermabond" liquid bandage in the OR. Minimal care...bath as you would intact skin, no additional dressings, and our post op leg infection rate dropped to almost nil-even with diabetic patients. Have your docs give it a try. Sorry I cant point you to documented published statistics but the change here was dramatic.

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