Advanced wound care
Yesterday was my first visit to the Advanced Wound Care Center up at Stanford. Fortunately, they are at the Redwood City location, which among other things has free parking that is close to the offices – so although it is further away, it takes about 15 minutes less time for me to get to the appointment. I also see my nail doctor there today – again, glad to be at Redwood City as Obama is at the main campus today making traffic, which is already bad, a true nightmare!
At the wound clinic the nurse measured the extent of my wounds. In particular, the ones on my stomach – which are actually two separate wounds – there is a bridge between them. In each case the wounds are a minimum of 1 cm deep with some tunneling on the edges. Fortunately, my insurance approved the SNaP system, so my surgeon and a nurse installed it (it takes two sets of hands to get the tape on. Scott took some before and after pictures (click link to see before picture: http://dttocs.smugmug.com/photos/i-ftLwSWg/0/M/i-ftLwSWg-M.jpg) and after:
What I’m liking most about it, is that I no longer need to change my own dressings. It is amazing how much quicker it is going to bed at night and get up in the morning when I don’t need to also change dressings. I’m also feeling a lot more mobile with this, than I did with the packed wet-dry dressings. I no longer need to wear an abdominal pack to soak up any seepage. I have, however, found that the hose has fallen off a couple of times. I’m armed with the primer stick that allows me to re-prime the device when it loses suction. So far, that has happened twice – once when I dropped the cartridge from my pocket (most be more careful with it), and once when I was jostling things around to find a comfortable placement in my clothing.
The cartridge itself is about the size of a deck of cards, but a lot lighter (it’s all plastic). The system came with a band that could be put on one’s arm or leg, but that doesn’t really work when the wound is on the stomach. I made a modification, using the clip from the leg band and one of the drain belts my surgeon gave me before my last surgery. This works well, as I can wear it in the middle of my stomach while sleeping (so I can turn from side to side in the night without it getting in the way). I also find that it works well under a t-shirt when I’m out and about during the day.
In some ways it is like having drains all over again, but in so many ways it is not! For one thing, don’t need to empty it. If the device gets full before a dressing change, then a new cartridge can be used. I also am not required to be on antibiotics with this device (unlike when I had drains). It does, however, require that I go to the wound clinic twice a week to have the dressings changed. So, for now until either the wound heals, or my next surgery (March 17), I’ll be going up to the clinic twice a week. It does feel a lot better than walking around with an open wound!
I learned something about wound care at the clinic yesterday – “structure” means the things under the skin (bones, muscles, fat tissue). As the nurse was filling out the EMR, one of the questions was “structure visible?”, which was true for Becky’s abdominal wounds, but not for her breast wounds. It will be interesting to see how the wound changes over the next week. Hopefully smaller…