Update on post surgical wound

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Saw surgeon on Mon she did a horrible job dressing the wound. Said she would set up home health which she did that same day. The homehealth nurse came today and freaked out. He says the wound is 5.5cm deep 2.5 wide and 4cm long. When he opened the bandage he freaked. He said it had copious amounts of foul smelling purulent drainage and my DH agreed. He immediately recovered it and phone my gyn. She said she wanted to see me so and to pack a bag. So off to Big City Er. They did absolutely nothing except culture it, slap some 4x4's on it gave me 4mg of morphine Iv and sent me on my way with instructions to phone gyn office for appt. The on call gyn was at the hosp and she had told me to come in so she could see it for herself and that I would most likely be admitted. ER doc said it is definately infected but the gyn never even came down to er to look at it. I am so confused. I am no wound care specialist but my homehealth nurse is. I am just so confused and a bit frightened. DH is calling ins co and explaining the whole thing and going to try to get a local doc to take over with thewould care. I am beside myself as to what to do and I am in alot of pain. I am just at a loss and my DH is livid.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

{{{{{{{{{{{{Angelbear}}}}}}}}}}}}

So sorry this has happened to you. CALL THE INSURANCE COMPANY STAT today. Ask to speak with a SUPERVISOR!

Did they at last put you on a broad spectrum antibiotic till culture report known?? Since you had a hematoma, sometimes that smell is just from old clotted blood.

I would have never left the ER until seen by OBGYM myself but sometimes babies just won't wait.

Tell the nurses to irrigate the wound well: our docs use 1/2 strength peroxide and saline; some just saline, sop up drainage with sterile 4 x 4's then pack with dry sterile dresssings, you need at least BID wound care. I've seen much larger wounds heal too.

PM me if I can assist you with insurance company/second opinion---it's what I do DAILY in homecare and I've got a winning record, don't take NO without a fight.

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Specializes in Med-Surg.

Sorry sweetie. Hope it gets better soon.

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Specializes in Hemodialysis, Home Health.

Oh, Angelbear.... this is just horrid. So very, very WRONG, negligent, inconsiderate, selfish.... this just should NOT be allowed to happen !!!

I feel SO badly for you, and helpless at the same time. I wish we could just round up a bunch of us here and run right over there to nurse you back to health... the RIGHT way... the CARING way.

Please take Nrs.Karen's advice and do get that BID wound care... how's your temp ? Did they not start you on Ancef, Tobra or ANYTHING 'til the culture result is back??? Geeeeeeeeeeeesh !!!

Poor Baby... please keep us updated... wish I could just "zap" myself over there....:o

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Specializes in MS Home Health.

I am also with Karen! Please take care of yourself and don't let anyone treat you bad or ignore you. You need help. Be loud if you need to.

renerian:kiss

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Anglebear, please, please contact Karen: your wound is NOT ok, you are getting jerked around and she knows the system.

Were it me I would: get on the phone with the OB/GYN office (again), tell them what is going on (again), demand to be seen in the office (again) and threaten to call an Atty. Then REPEAT every 30 minutes.

Do you know a general surgeon that you have a good working relationship with? If so you might call their office, manipulate a bit to get his/her actual nurse on the phone (I have said this is Nancy RN from facility X to identify myself and let reception think it was an official call) and tell the nurse everything that is going on. I have "pulled" this to get appropriate care. (I hate to admit to doing that)

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Specializes in LTC, assisted living, med-surg, psych.

((((((((angelbear))))))))

Seriously, it sounds like you're getting to be a candidate for a wound vac system. I can't believe the runaround you've been getting while all the time your wound is growing God knows what kind of flora and getting deeper. (Can anyone say "LAWSUIT"?) Someone needs to be held accountable, NOW, before you wind up being overwhelmed with sepsis, or worse!:(

You will be in my prayers, honey.:kiss In the meantime, are you on a good multivitamin/mineral supplement? How about Vitamin C and zinc? When I worked in long-term-care, it was standard practice for me to ask the MD for these whenever someone came in with wounds or pressure ulcers, and you wouldn't believe how much they helped. Vitamin C 500mg. was given twice a day, and the MVI was given in the morning with breakfast. One caution with zinc: if you take the effective amount (220mg elemental zinc QD), be sure to take it for a maximum of 6 weeks....otherwise you run the risk of developing a copper deficiency.

Please keep us posted on your progress, and consider trying the vitamin regimen if you aren't on it already.

Good luck! You certainly deserve it after all you've been through.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Got a PM from Angelbear that she has a great homehealth RN doing wound care who was going to arrange for wound vac today. Just hope it's covered by her insurance plan

Mjlrn97, agree with MVit recommendations.

Forgot to metion need for increased high quality protein intake minimum 4 servings a day, along with fluids to prevent dehydration and aid in wound healing. Snack on cheese, meat sandwich rather than cookies and cakes too. I'd drink a carnation Instant breakfast or Ensure suplement too each day. Not the time to conserve on calories.

Awaiting your latest report Angelbear....crossing my fingers too!

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Originally posted by angelbear

Saw surgeon on Mon she did a horrible job dressing the wound. Said she would set up home health which she did that same day. ....... I am no wound care specialist but my homehealth nurse is. I am just so confused and a bit frightened. DH is calling ins co and explaining the whole thing and going to try to get a local doc to take over with thewould care. I am beside myself as to what to do and I am in alot of pain. I am just at a loss and my DH is livid.

:rolleyes: I laughed when I read the first line of your post. Very rarely have I met a surgeon who could do a decent job of dressing a wound!! They just do the cutting, the nurses are supposed to take over after that! I've often been called out for an extra visit to a patient who'd just been to their doctor, and the doc. had torn off the dressing, and 'redressed' the wound (often, if it's a fairly clean wound, they'll just replace the old dressing) So, then, of course, they send the patient home, and the dressing is falling off, or leaking.... Happens all the time in home health.

Angel, in my experience, home health wound care nurses are the best. Very few hospital nurses can match them for wound care knowledge. The vast majority of them know more about wound care than the doctors, and if the doctor is a good one, HE knows that too! Vac therapy is an excellent way of dealing with the sort of deep wound you have. Another good treatment is iodosorb paste. It does a good job of getting rid of the bugs, but unlike full strength betadine is not so strong that it kills healthy granulation tissue too. I've seen it work miracles. One of my first experiences with it was a guy who'd had a colostomy, and got a postop infection in the incision. We were packing the wound with about 4" of 1/4" ribbon gauze. We started using Iodosorb on the gauze (just spread it on like it's butter, said our wound nurse) and it went from 4" of gauze to totally healed in about a week!

{{{{{HUGS}}}}}} to you, and I hope you can find a good doctor to supervise the care of this wound. We are fortunate to have some excellent doctors who specialize in this area. Some are plactic surgeons, some are vascular specialists, and I think there's even one who's an orthopod!

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Just wanted to let you know wound vac did not arrive today. Homehealth nurse did get it approved and even got the freedom vac he had hoped for but it wont be here till tomorrow. I am doing fine though temp is down and so is pain level. He did instruct me to increase fluids and protein which I have done. Hubby is trying to force feed me cottage cheese every 5 min. Thanks for caring and all the good advice. I am feeling really alone stuck in the house. I do have a quick question. I am do to return to work in 3.5 weeks is it likely to be healed by then?

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Specializes in LTC, assisted living, med-surg, psych.

It depends on a lot of things.....your nutrition, response to the antibiotics, and of course how well your wound vac nurse is trained in using the apparatus. I've seen remarkable progress in wounds such as yours in a matter of 2-3 weeks, if all goes smoothly. Being young and reasonably healthy, I like to think you'll make good time in recovery, but not having actually seen the wound I really can't guess how long it'll take to heal.......just don't be surprised or disappointed if you are NOT ready to go back to work in 3 1/2 weeks.

Someone mentioned in another post the concept of a high-protein diet, which is vital in wound healing. This is not the time to worry about watching your weight.....you need those calories to supply the energy required to rebuild all that damaged tissue. And don't forget the vitamins & minerals!:)

Good luck with the wound vac.......I think you'll be pleased with the results in the long term.

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I feel so bad for you. How awful! Here is the website for the wound vac. I really think that would be beneficial for you as well as the extra protein & vitamin c & zinc in your diet. http://www.woundvac.com

Please keep us updated on your condition.

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