TIB/FIB wound

[zacarias, ASN, RN]

Hey all,

I have a trauma patient who almost had a tib/fib amputation, but they did an ORIF and now it's an open wound. Well Plastics ordered wet-to-dry dressings (I know I know) for the wound and we are doing those. I looked at the wound yesterday and it seems like there's more granulation tissue than before. I think it's over muscle although touching it, the "muscle" didn't seem to contract much when I moved the leg. Over one part of the tissue there seemed to be a sharp point, almost like what a pokey splinter feels like when you run your hand over smooth tissue. Any idea on what that is?

Anyway, the bone side of the wound is not granulating much at all but the other side has tissue is now like 2mm above the skin edge. It sounds like "proud flesh."

Wound care was consulted from the hospitalist. The wound care nurse subsequently said that on this she had no authority, she deferred all to Plastics. Grr....