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How often are post op dressings routinely changed? Our hospital is trying to say that we should change them every day unless the physician writes a "Do not change dressing" order. What is everyone else doing?
QD dressing changes sound logical depending of course on the extent of the wound and the amount of drainage from it. If you are talking about incisional care that is usually done daily unless otherwise indicated by the MD. It is always good to clarify any wound care orders with the surgeon, even for the smallest of wounds to cover yourself in the event of infection or other complication.
At my hospital, initial dressing changes are done by the docs. After that, we require an order. If the wound is open, once a day is not enough. BID is the minimum for an open wound. If the wound is closed and dry, when the initial dressing comes off, no other dressing is required. If it oozes, it can be covered at nursing's discretion and changed PRN.
hi....in response to your question about dressing changes....we support a large number of general, vascular and thoracic surgeries.....without exceptiuon, as soon as the incision has stopped its initial ooze (usually within the first 12-24 hours), we leave it directly open to the air. We deal with a lot of dirty bowel resections, so outr infection rates are understandably higher, but we feel this is due to the perforation preop and not the lack of a simple dressing postop. Of course, if any incisions are opened and require packings/debridements or simply need a dressing to facilitate nursing management (like in a large person's abd skinfold), then we may certainly use our discretion. Hope this helps !!!!
Original post op dressing is changed only by the surgeon, then per his orders only. If the nurses think it is not being handled correctly, we call his office and ask for a consult from the wound care nurse, usually they agree, and the WCRN team looks at it and writes orders, usually he/she will go along with them.