space between incision and vaginal opening.

  1. RMy patient initially had a skin graft to cover the anal opening. The incision goes down to about 2mm above the vaginal opening. I have been spending a LONG time on home health visits to this patient due to having so many problems trying to seal the rectal wound (like a HUGE) episiotomy from the extremely narrow space between the incision and the vaginal opening. Any ideas??? I have tried Eakins seal and stoma paste but the area is so small. I am needing to do this by myself while the inpatient wound care required two persons. I am grateful for any ideas to accomplish this.
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  2. 4 Comments

  3. by   Davidaugustyn
    More detail. Does she has an ostomy? Or stooling out of the wound? Not sure.
    If I understand, you're trying to heal up the entire rectal area (rectal CA?)

    The one patient I had, we use a silvadene slurry (I know we don't use silvadene any more)

    We just never got a seal. half and half saline and silvadene soaked kerlix with ABDs over the top and a netting underwear and foley cath. She had an ostomy though...
  4. by   BabaLouRN
    she does have an ostomy. The anal wound was being repaired following removal of a large mass on the rectal muscle.
  5. by   Davidaugustyn
    I would stick with what I said than. Maybe not silvadene, but a good moisture correct environment and diaper it up.
  6. by   mommy.19
    It is difficult to give advice without being there but you can also use a protective layer over the any sutures near the vaginal opening and then apply a strip of duoderm. Sometimes I use duoderm thin like a fruit roll-up, if you will, and place that where i normally would use an eakin seal or paste.

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