Question:
need some tips on packing wounds

I had gallbladder surgery on 8/23/05 and due to my gallbladder rupturing (and my surgeon not telling me or sending me home with an antibiotic) i developed 2 abcesses that now have to be packed daily. One is at least 4 inches deep and the other about 2. My ? is, is there a way to make it less painful? When DH packs the top one (4inch)it hurts so bad that i get dizzy and sick to my stomach. The bottom one isnt bad b/c im still somewhat numb from my TT in May.Pain meds help some,but its like pulling teeth to get them.Oh, how long were u on pain meds with the abcesses? I have a low tolerance for pain when it comes to my abdomen and teeth, so i really need them. they only take the edge off, i havent been pain free in well over 4 months with the TT and now this.I would appreciate any advice or tips you can give me..thanks again Amy RNY 9-16-03 260/110/105    — cinamoni (posted on September 6, 2005)


September 6, 2005
I am assuming you are packing the wounds with gauze and normal saline. Is there any reason you doc might object to using some sort of topical anesthetic in the wounds before they are packed? There are water soluble lubricants with anesthetics in them, and I am sure there are some you can spray on. I am not an expert but it sure seems like there has to be a better way to get things done. Take care!
   — koogy

September 6, 2005
Try and get some gauze with antibiotic already in it. My friends mom had hernia surgery and her incision ruptured. This had to be done for months. Contact your doctor and see what they ahve to say. God bless.
   — LilaDove

September 6, 2005
I honestly think that you should have a home health care nurse visit you at least 3 times a week, to check that the dressings are being put on correctly, to change the dressing when he/she is there, and to answer any questions that you or DH has about the dressing. He/she should also get a good look at the wound, and report back to the doctor regularly. Having to pack a small wound twice a day (like I did for my mom years ago)--an arm incision about 5 inches long, about one inch wide-- it closed up almost completely after 2 weeks (and she was a diabetic). And, of course, I am NO nurse. Any more than that, I think a qualified medical professional should be caring for.
   — Cisbell

September 6, 2005
im going to ask about the home health nurse. Im very nervous with my hubby doing it. not that he doesnt know how its just its very painful and i want to make sure it heals completely and hopefully doesnt scar so bad (just had TT in May). I hope it gets better soon...thanks for the advice <3 Amy
   — cinamoni

September 6, 2005
Hi Amy, I know what you are going through !! I had a hernia repair and ended up with a large open wound due to infection. I had 2 different surgeries to open it up and cut the dead infected area away. I went home with a hole big enough to put my fist in - if I remember right it was about 6 inches ong & 3 inches wide and I can't remember how deep. I was in the hospital 1 week and I had the packing bit for the first 2-3 days at home but a Home Health nurse came to do it twice a day. She would make sure the packings were moist enough before pulling them out slowly. As far as packing the area she made sure the packing was pretty wet before putting it in. I was kinda numb but felt lots of pulling/tugging inside that made me nauseated during the dressing changes. I also was on Lortab which is a kind of Vicodin and took this about 30 - 45 minutes before she came. I ended up with a Wound Vac from KCI and wore this for 2 months before I finally healed. Home Health also came 3 times a week to change this. I was on Lortab about 2 1/2 months. I would ask for Home Health - my insurance covered most of her charges which were about $144.00 a visit 2 yrs ago. Good Luck to you , Kelly
   — Kelly B.

September 6, 2005
I had an open wound when I had surgery in Nov. We always made sure it was very moist before pulling the packing out. We would pour a small amt of saline in there before removing the packing because the gauze will dry and adhere to the sides of the wound which hurts like h@*# pulling out. Other than that I have no other suggestions.
   — horserider0146

September 6, 2005
im on medicaid so im not sure if they will cover a nurse. My surgeon is refusing to give me anything for pain. I know im not being a baby as these really hurt. And even with vicodin it didnt take the pain completely away just tolerable. I dont know what to do but i know that i cant rest b/c it aches and burns all the time. I think i got a surgeon who just doesnt care...its been a horrible expierence since the beginning-thank goodness below my belly button is still kinda numb so that one doesnt hurts as much but i wish it was the really deep one that was numb. My doc didnt tell me if i had lifting restrictions or anything what did ya'lls doctors say?? Thanks again for the info love Amy
   — cinamoni

September 7, 2005
Amy If you are on medicaid and you are able to drive then medicaid usually will not pay for a home health nurse but they will pay for you to go to outpatient at a physical therapy place or a hospital for wound care all you need is your Dr. to write a prescription for it. Call the hospital where you were a patient at and talk to the patient care cordinator and see if they can help you usually they make all those arrangements before you leave the hospital. The wound care team may also reccomend to your Dr pain meds for you to take for wound care treatment times it helps them to better do your wound care if you are comfortable. Hope this helps...Nancy
   — nefish

September 8, 2005
Just an FYI, is you are doing a wet to dry dressing change -where you put the gauze in and it is wet, the idea is that it dries in the wound and when you pull it out, it brings along dead tissue and drainage. Moistening the gauze before removing it defeats the purpose of a wet to dry dressing change. I really do agree that you need to have someone teach/observe your husband's technique in doing the dressing changes. You can always call a home health agency in your area, explain that you have Medicaid and what is going on. They might be able to do a couple of visits for teaching and training purposes, even if you are not homebound.
   — koogy




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