一般及消化系外科

衛教單張編號:A7510008
 
Surgical Wound Home Care
外科手術居家傷口照護(英文)
By 一般外科、7A病房、7B病房 | December, 2020

1.Preparation of Dressing Change
Choice of Antiseptic Solution Sterile cotton swabs Dressing Others
□Saline
solution
□Aqua beta-iodine
□Aqua Easy Antiseptic Solution 2% (Blue Cap)
□Easy Antiseptic Liquid 2% (Red Cap)
□Other:
□Cleaning cotton swabs
□Cotton swabs for oral care
□ENT cotton swabs
□Other:
Gauze:
□2*2
□3*3
□4*4
□Y-Shaped
□Transparent Film:
□Other:
□3M™ Micropore™ Surgical Tape
□Baby Adhesive Tape
□Yu-Ki Ban
□Gloves
□Other:
2.Purpose of Dressing Change
Prevent post-operative wound infection and enhance wound healing.
3.Dressing Change Schedule
Change the wound dressing once daily (or follow the physician’s instruction for the number of dressing change). Change the wound dressing immediately in case of wound exudate, gauze coming off, or accidental moistening.
4.Dressing Change Procedures
  • A.Wash hands.
  • B.Supplies.
  • C.Remove gauze, observe wound.
    • (1)If the gauze sticks to the wound, do not remove with force. Use normal saline to dampen before removal.
    • (2)Observe the nature of the wound for any redness, hot, swelling, pain, and the color, property and quantity of discharge.
  • D.Disinfection
    • (1)Disinfect with aqua beta-iodine → After 30 seconds → Wipe with normal salinev → Cover with gauze.
    • (2)The area of disinfection should be at least 5cm greater than the wound.
    • Note: When using Aqua Easy Antiseptic Solution or Easy Antiseptic Liquid 2% for disinfection →Cover with gauze.
  • E.Cover with gauze
    • (1)Take the gauze and cover the wound. Take only the corner or edge of the gauze. Do not touch the side of the gauze covering the wound to prevent wound contamination.
    • (2)Finally, use the paper tape to fasten the gauze. If the skin is vulnerable, choose anti-allergy tape such as Baby Adhesive Tape or Yu-Ki Ban.
5.Definition of Exudate Amount
※Note: If the exudate is clear rather than purulent exudate, increase the number of dressing change.
6.Instructions for Wound Care
  • Follow the instructions to use proper antiseptic solution or apply antibiotic ointment. Do not apply ointment of unknown origin.
  • In case of infectious signs appearing in the wound, i.e. fever (higher than 38℃), red wound and swelling, pain, odor secretion stench, or fallen wound thread, return and make appointment for the clinic of general digestive surgery on weekdays, or seek for medical evaluation at the ER on the weekends.
  • The physician at the clinic will assess the time to remove the stitches on the wound. Before removing the stitches from the wound, bath with damp towel and do not shower to prevent wound infection.
  • Adhesive Skin Closure:
    • Preventing the proliferation of granulation tissue and inhibiting the formation of scar tissue.
    • The adhesive skin closure is for the inner layer of the wound with absorbing stitches that does not require removal. After the adhesive skin closure falls off naturally or gets stained, change the adhesive. Or, change the dressing, if needed.
    • The adhering time will be the first return-visit to the clinic after discharge from the hospital. The physician will evaluate and if the adhesive falls off before returning to the clinic, dressing change will be required.
  • Waterproof Gel:
    • Apply on the surface of the wound during the surgery. Usually it does not require change of dressing. In case of exudate appearing on the post-operative wound (failure with waterproof gel), proceed with general dressing change for wound.
    • Do not “rub” the site applied with waterproof gel. Pat the skin dry gently after the shower. The dressing will come off in about 1 week.
7.Q&A for Wound Care at Home.
Q What should the patient do if experiencing pain and discomfort in the wound?
A ★Take the painkiller by instruction to improve the pain. Make appointment to return to the surgery clinic if necessary. Discuss with the physician for the medication treatment upon revisit.
★In case of experiencing severe level of pain intensity in the wound in hospital or at home, and if taking painkiller does not improve the condition, seek for medical treatment a the ER immediately.
Q What should the patient do if the wound skin feels itchy?
A ★Post-operative wound- Fibroblast produces massive collagen to repair the skin. After the scabbing and epidermal regeneration, new skin will grow in about 10 days. It will be normal to feel numb and itchy during wound healing period.
★Skin area-if the site adhered with tape causes skin redness and itchiness, it is recommended to change the tape to Baby Adhesive Tape or Yu-Ki Ban.

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