Don't You Need to Change the Dressing for My Wound Today, Doctor?
One of the questions often asked by hospitalized patients after surgery is whether he or she needs to change the dressing for his or her wound today or tomorrow. If he or she does not change the dressing for two or three days, he or she will ask the doctor everyday for fear that the wound will be infected because of the failure to change the dressing.
This is mainly because patients do not understand the purpose of our dressing change. Surgeons want the wound to be in a sterile, dry environment, which heals faster and has the least chance of infection. In the following cases, patients need to change their dressings.
① After surgery, the wound is wrapped with gauze and other accessories, which separates the wound from the bacteria in the outside world. The movement mode of bacteria felt that it was difficult for them to reach the wound through the dry gauze, but the wound was soaked due to oozing blood and fluid, etc. There is a moist passage between the environment and the wound, and the bacteria from the outside can enter the surface or even the inside of the wound. At this time, we need to change the dressing, analyze the cause of bleeding and seepage, disinfect, rinse and wrap up the dry gauze. This re-establishes a sterile and dry healing environment on the wound surface.
② Sometimes, the patient's wound will appear fat liquefaction. Fat liquefaction occurs when the fat underneath the incision is stimulated and the fat cells die, dissolve, and the dissolved oil seeps out of the wound. There are patients around the wound will have blood, hematoma, also easy to repeatedly ooze blood. The skin on our wounds only heals when it's dry, and this constant seepage can slow the healing process. So we should often change the dressing, observe the improvement and healing of the wound.
③ some patients with suspicious wound infection, or suspected wound inside the purulent. At this point we have to change the dressing every day, even remove some stitches, leave the incision open and let the dirt out. Sufficient drainage is helpful for treating suppurative infections, and the surgeon will change your dressing daily or every other day to ensure smooth drainage of the wound.
④ if after 1 to 2 times of dressing change, you find that the wound has been completely dry, no longer ooze, at this time for a good dressing can be many days without dressing change. Because each time the dressing is opened, the bacteria in the outside air increase the chance of contact with the wound, it is generally not necessary to open a dry wound frequently unless necessary observation is performed. Let it heal in a dry, sterile environment.
In summary, the purpose of dressing change is to clean up the contaminated material, observe the changes in the wound, deal with the cause of the wound oozing blood, detect early signs of infection, and allow the wound to heal in a dry and sterile environment. So, when your wound is dry, changing your dressing every day may do more harm than good. If your doctor doesn't change it for a few days, your wound is very reassuring!
Surgeons usually do not spend much time in the ward because they have both operations and outpatient services. If in such a busy situation, the doctor runs to your wound every day, then you really have to worry.
Do I need no powder for my incision dressing change?
The growth of the wound granulation requires a sterile wet environment, and the healing of the skin requires a sterile dry environment, in addition to this, as little as possible to interfere with the growth of the incision. So we usually don't use it on the surface of the wound. But each time the dressing is opened, the wound comes into contact with airborne bacteria, which should be disinfected with iodophor. After disinfection the wound is intact with sterile gauze wrapped up on the line.
How long will my incision take out the stitches?
The incision can be removed only if it has fully healed. The healing time of the incision is determined by the blood circulation around the incision and the presence of infection. All the nutrients we eat need to be carried throughout the body by the blood in the blood vessels, including the incisions. If the blood supply of the incision site is very rich and the circulation is very good, the healing will be fast, otherwise, the healing will be slow. As a result, the time of removal of stitches for surgical incisions in different parts of our bodies is different.
Blood supply here is very rich, generally 3~5 days can be removed stitches. The head is the center of resources, once there is a need, the doctor will immediately be able to mobilize a large number of energy supplies, quickly solve the problem.
Face and neck
The blood supply here is also abundant, second only to the scalp. Nothing unexpected 5~7 days to remove the suture is enough. These parts are also the places where a large number of vascular networks gather, so that in case of problems, energy supplies can be mobilized to solve the difficulties in the first time.
Chest and abdomen, upper arms, thighs, perineum, buttocks
The blood supply here also belongs to the better, generally 7~10 days to take out stitches.
Back, forearm, calf
10 to 12 days.
The incision around the hand, foot and joint and the tension is relatively large.
12 ~ 14 days. The hands and feet are farther away from the heart, so the blood supply is poorer. In addition, the time of repeated flexion and extension around the joint should be about two weeks because it is related to postoperative rehabilitation exercise. For the incision with swelling before operation or abdominal tension reduction suture, the opening force is too large, which affects the local blood circulation of the incision, and it also takes 2 weeks or even longer.
There are some special cases where removal of stitches needs to be delayed.
The incision of calcaneal fracture, because the blood supply of the calcaneal bone is really too poor, the suture removal is generally delayed to 3 weeks after surgery.
There is a long time of exudation or exudation of the wound, generally to the wound dry after the start of about 1 weeks of suture removal.
In elderly patients with poor nutritional status, hypoproteinemia, or diabetes with poor blood glucose control, the incision should be delayed accordingly.
And if the wound becomes infected, you can't rush home. The surgeon's treatment plan, debridement for debridement, and secondary surgery for secondary surgery, should be followed and followed to minimize the adverse consequences of infection.
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