wound vac post ileostomy

[agichk]

I had my ileostomy on 3/4/19. Wound up and down had 46 staples. He took some out 3 weeks post op and the rest out last Tuesday.
He opened 2 areas that were not healing well 10 days ago.
Wound clinic last Friday for 3 hours found the top wound above umbilical area is 80% dead fat and lower one is very much deeper and harder to see but told 25% dead.
We have been doing wound ointment Santyl in both wounds than packing it with moist gauze than dry gauze finished by abd wound pad.

Decision made 2 days ago to do the wound debridement under anesthesia and place wound vac on Monday morning.

The lower wound is very close to the side of the barrier on left side and concerned about trying to do bag changes with wound vac in place for starters.

2nd concern is pain management as previously had wound vac in 2017 for 6 weeks and they could never get the pain mgmt plan figured out in hospital or home. I know Valium does nothing to help me and actually makes things far worse. I think they tried 10 mg roxicet (liquid oxycodone) and did nothing.
I have read to have them put saline on the wound to get the packing out each time. what about getting the adhesive dressing off?

What does of the morphine drops did someone do previously?

[Mysticobra]

I feel for you.
Nothing short of demoral would take the pain away when taking the sticky wrap they place over the belly to hold everything in place.
When I was sent home and the nurse came out to do the change it would take half an hour as opposed to five minutes in the hospital. Dreaded that tape. Ugh.
I use an adhesive release spray to get my wafer off for changes. I wish I would have known about that before. I certainly would have used it.
You may want to mention using the adhesive releaser spray to get it off.
It has to help some.
Richard.

[Diane C]

Wishing you luck and wish I could help you. So sorry re the need for the wound vac and the pain. I didn't begin to approach what you're dealing with in the area of wound care but know people up here -- like Richard -- can help.

Sending healing wishes!

Diane C

[Button]

My experience with the wound vac was not bad.

The nurses irrigated the area with copious amounts of bottled saline before removing the dressings. There was no pain as the dressings were loosened and untethered by the saline.

Like Richard, the home health nurses that I had used an adhesive remover spray that minimized skin trauma in removing the wound vac’s outer adhesive dressing.

Talk with your home health nurses about ways to lessen skin and wound trauma during dressing changes. I hope you have a better experience with the upcoming wound vac. Fingers crossed.
Karen

[agichk]

Thank you guys for the suggestions.

I will be going to the outpatient ostomy/wound clinic as the hospital's HH is short 2 nurses for my area of the county I live in.
I do not want to deal with another HH company after my experience post ileostomy with nurse out 10 days later and admit being 2 hours of me answering questions and her inputing all meds, allergies after writing them down on paper.

I will ask them to use the release spray as they are the ones who introducted me to that on April 2nd. I love it when it comes to the bag changes as helps mainly with the ring.

I will for sure ask them to do the saline as right now my husband has to do this for the wound changes and it is still bleeding when not pulling on any tissue. He figures less than 1/4 inch from barrier of stomy to wound currently.

I appreciate the information, suggestions and help. I am taking 3 bags and supplies to hospital as I do not know what I will wake up with but it won't be a hollister bag.
thank you guys.

[Mysticobra]

Good luck to you.
I know what your going through is not pleasant..
But you'll make it. Seems like forever when your doing it But it will come to an end.
Richard.

[agichk]

Thank you Richard. I know this will speed up healing and lessen the time of healing. it is the right treatment for the issue.

[Mysticobra]

Your right in your thinking.. That's for sure.
Omgoodness. Not even I thought about that while going through it. I couldn't think.
I figured it was another way to torture me. Lol.
Richard.

[agichk]

I had an excellent experience at the hospital. I have to make sure I get up often as get very sore otherwise
the wound nurse gave me a soft inflated cushion to sit on while there and boy did it make a difference in ability to sit w/o butt hurting. I knew that i have a small red area since ilesotomy surgery due to the weight loss and putting A&D ointment on daily after bath to try to protect it.

they instill Lidocaine thru the wound vac tubing prior to doing anything.
Of course I take pain med 30 min prior to appointment also.
they use the release spray to get off dressing.
I am going 3 days per week to clinic to get dressing done.
I will say that I won't be bending down to get stuff off the floor unless sitting down already and lifting legs over the 90 degree angle for hip to knee is also out.

I am not sure how long will have the device though appointments set thru May 31st.
It has been a positive experience and not in hospital due to illness so that really helped.
Ostomy change tomorrow will be interesting as part of the dressing is on the barrier. Going to see how tomorrow goes and get help with suggestions on Monday when there again if needed.

Surgeon so happy to see the stoma so small as means the small bowel is no longer dilated to 8cm in many places. No obstructions means good news.
Surgeon offered 2 nights ago to reverse the ostomy in a year post healing maybe if I wanted. Not sure that offer will be taken up.

[Button]

Agich:
Glad to hear that the incisional wound debridement accomplished what it needed to do and that you are on a better pathway for healing.

Nap. Walk. Watch a NetFlix movie. Give yourself permission to rest and recover.
Karen