Infected incision-what would you do?

[HomeCareFun]

Hello!

This my first post on all nurses. :-)I wanted to get a consensus of what you would use on an infected surgical incision. This is a BKA, and the patient is diabetic.

The surgical incision is about 13 centimeters across, but not much drainage. Serous and slightly purulent drainage, minimal. Some redness around the incision itself, but this poor lady managed to slip and slam her incision on her wc, reopening part of the incision. No odor. I think the redness is more from the leg hitting the wc vs an infection. She edges are approximated, sutured. One part of the incision has yellow edges. No oozing. It isnt slough, it's pretty firm and pretty much like the rest of rhe incision but it's yellowy.

What would you dress this with? I'm inclined to use Bacitracin or Silvasorb along the newly sutured part, cover with telfa and kerlex. Any other suggestions? I've also seen hydrofera blue on these, but egads is that expensive and i dont see it working better than the other stuff. Docs usually leave the tx protocol to us and they sign the orders.

Thanks so much!

[Rose_Queen, BSN, MSN, RN]

What does the surgeon recommend? I would certainly hope that someone contacted him/her that part of the wound is open and infection is present.

[HomeCareFun]

Yes, Surgeon was the one who sent the wound care eval and tx order. He is seeing her weekly to monitor. I was just curious what different protocols people have seen for this. I see the wound clinic always using the newest thing that the sales reps bring them.

[Davidaugustyn]

How many days old is it? Is it appropriate redness in the inflammatory stage?

Lots of times it's just a hope that it doesn't dehisce. I wouldn't use topical antibiotic, not best practice. Really I have not seen much help from the outside on an approximated wound.