pattc

I've never been able to wring out a swab enough to prevent some spillage over the surrounding skin, or in this case, the wound, due to the close proximity. The swab would have to be dry to prevent even this minimalistic amount, which defeats the purpose. It's not like a bucket of water has been splashed all over them. And skin flora are microbial and need little mode of transmission to move alot of bugs

LOL. ... the person is erect so cleaning the incision first Then the area directly above the incision will cause downward gravity flow into the incision. Picture the mastectomy scenario with the patient sitting erect to have the dressing changed. Unless the swab is dry, it is likely fluid will flow downward towards her lower torso. Therefore, cleaning the area above the incision FIRST will result in gravity flow of N/S carrying skin flora toward the lower torso and over & into the incision

What happens is fluid from the swab used for cleaning (unless it's nearly dry or little to no pressure is applied) flows over the already cleaned incision through gravity if the person is in an upright position. Picture a mastectomy incision and the patient is sitting erect. How and where would the fluid flow? Optimist would use the same technique that I would use.

Hi Everyone This is a sort of poll but I am looking for opinions/advice. Everyone knows an incision is cleaned first with wound care starting from the cleanest to the dirtiest. I have a conundrum. If the wound is placed in a position where the N/S can flow back over the previously cleaned wound ( bringing skin flora with it) which is the best method to use? eg horizontal wound on upper torso and patient cannot lie back so must remain in fowlers or semi fowlers I feel cleaning over the wound first would give the opportunity to limit skin debris from settling into the wound, especially now that drying the wound itself is not recommended. So, for this type of wound I would clean (first) top area over the wound (second) wound itself (third) lower area under the wound. area over the wound ----------- (1st) wound ________ (2nd) area under the wound ---------- (3rd) I have had agreement with IC staff and surgeons but disagreement with peers. I have found little documentation on this subject Let me know your opinions.... especially wound care specialists Thanks Pattc

Hi I have also had this problem and whether due to aging or childbirth causing prolapse of the lady partsl canal, anatomical issues or disease related, it can be extermely difficult to successfully catheterize the patient. I have had several which using the thumb to retract did not work due to the meatus being hidden farther into the lady parts. I have found positioning the patient on their side with the top leg slightly elevated by a support or an assistant works best, if the patient's condition allows. It may be too painful for a post op or back injury such as sciatica or disc. This position gives much better visualization, access and ability to insert in a downward motion rather than the elusive upward (which is where the meatus ends up so insertion is mostly blind) making it less likely to place the catheter into the lady parts. Personally, I think all females should be catheterized this way unless their condition prevents this positioning. There would be more success with first attempts and possibly less infection and trauma Thanks Pattc