S/P I&D - What's this mean?

moshimoshi said:

As a nursing student, I took one diabetic patient with non-healing cellulitis on his left foot. After the patient had a debridement, the doctor wrote an order, "S/P I & D." I understand it stands for "Status post incision and dressing." (My RN told me.) What exactly does this mean? What are my nursing actions for this doctor's order? Thank you.

I understand it to be "status post incision and debridement" - and just that statement alone would not be construed as an order unless your unit has a standing protocol or order for that sort of thing?

Further orders depend upon your facility's protocols, whether the wound is packed and/or wet/dry dressings ordered, etc. In some cases a WOC (wound, ostomy, continence) consult is needed.

At the very least you want to assess the wound and dressing, the patient's vitals and condition post-op. If antibiotics or other meds are ordered make sure those are given as ordered. check labs.

It doesn't sound like your RN gave you very complete info, check with them again, another RN on the floor or your instructor for clarification. As a student you should not be left on your own to figure out what to do since you are obviously new to clinicals.

My understanding was it usually meant "status post incision and drainage," usually done with a wound that may have closed but has underlying infection.

It makes sense since he deos have MRSA and under standard precaution. Are there anything as a nurse I should be doing besides checking VS? I remember his dressing had many many layers yet blood was still soaking through. What should I be doing with that kind of dressing? Thank you.

It makes sense since he deos have MRSA and under standard precaution. Are there anything as a nurse I should be doing besides checking VS? I remember his dressing had many many layers yet blood was still soaking through. What should I be doing with that kind of dressing? Thank you.

If it's the surgical dressing, call the doc & inform her/him that the dressing is saturated. If it's not the surgical dressing, get orders to do dressing changes & wound care. It may need irrigation with saline & wet-to-moist (or w-to-d) changes bid or tid. Also, document what you see with each dressing change & notify MD if there are any signs of necrosis or new infection. Finally, you will probably administer antibiotics per MD order; monitor pt for any s/s of systemic infection, such as temperature & changes in lab values (increased wbc count).

I believe that it means surgical procedure incision and drainage. I'm not sure of the same, however.