Most of you know that @zakludick was in hospital recently for a seemingly harmless wound that turned septic and caused cellulitis - a very dangerous bug- to spread. After being on oral antibiotics, then intravenous antibiotics, and both not effectively clearing the infection, surgical intervention was required to debride the wound.
. This has meant that, as "chief medical consultant"😜, in our household, @zakludick 's post-operative care has become my responsibility. I use the term responsibility loosely there because I find that I love looking after my family.
I have been absolutely pedantic about dressing changes and keeping everything sterile as we certainly don't want any kind of reinfection after what we've just been through.
If you're a little squeamish then I advise you don't read on, but honestly, Zak is doing excellently and the wound is closing nicely. It's at the end that most people become relaxed in their routine, not caring much for the whole process, which often leads to unnecessary reinfection to a still fragile wound area but I will be monitoring him closely until the wound is completely closed.
Here is a step-by-step guide of how I have been looking after @zakludick and treating his wound.
Tools:
- sterile scissors (although I don't always need them, it's important to have them on hand)
- A dressing pack - we buy these from the ambulance supply store across the road as it's far cheaper than the pharmacy. Plus, the chances of a pharmacy stocking these are slim to none. These dressing packs consist of sterile gloves, gauze, a bin bag, an absorbent towel, and sterile cotton balls.
*Saline solution for cleaning
- in our case, a 9cm by 10 cm adhesive wound dressing
**1. **Firstly, it's very important to make sure your "patient" is comfortable. We do dressing changes upstairs and away from the kiddos as it's both the most comfortable place for both of us and it's an area I can control regarding cleanliness.
2. I always "scrub in," washing by hands thoroughly - right up to the elbows!
3. Once my patient is waiting and I have set up my wound care area next to my patient before I do anything with regard to the wound dressing change, I put latex gloves on. Obviously, you use a fresh pair every time.
**4. **Then you prepare the area with an absorbent and sterile "towel" for the absorption of excess fluid, which is mostly just saline from cleaning.
5. I open the red medical waste bin bag and make sure it's close enough for me to reach conveniently as I am going through the process of the wound dressing change.
6. I then remove the old dressing and note the level of exudate, which in Zak's case has been steadily decreasing wonderfully. I then discard the dressing into the red medical waste bag.
7. I then open the bottle of saline (it's better if you can get individual-use 30ml bottles, which is just enough for a dressing change, but the ambulance supply store across the road from us was out of stock, so I bought a liter of saline solution. I pour a little into the dressing pack tray which is a clever trick I learned from working in wound care. This will be used for cleaning the area around the wound and the wound itself.
8. I start at the edges of the wound, cleaning the area of the previous dressing. I use sterile gauze for this process. I am extremely careful to not let excess water to drip into the the actual wound area. I clean the wound last which basically consists of me gently dabbing the area with a clean gauze sheet and saline. I go through about 8 sterile gauze strips, throwing each one into the medical waste bin bag that I opened earlier.
9. The next step is to make sure the area is completely dry to ensure that the new dressing adheres properly to the wound area. I had to shave around the wound area as Zak is a little fuzzy, in a manly way, of course, and the excess hair was interfering with the adherence of the dressing. Once again I use sterile gauze for this and discard as I go.
10. Then the dressing part starts. I squeeze a little of the prescribed topical antibiotic cream onto a piece of sterile gauze -folded to size. It is EXTREMELY important not to apply any kind of ointment directly from the tube onto the wound as this will compromise the sterility of the ointment.
11. I then open the dressing itself. I carefully apply this over the folded gauze, ensuring all the edges are smoothed down to remove air pockets and that the dressing properly adheres to the wound. I then remove the top layer of the dressing by lifting from the blue tab. This leaves me with a clean and brand-new dressing!
