What to put in an open wound so packing doesn't stick
October 25, 2023 11:16 AM Subscribe
I have an open wound on my belly that's been left open to heal on its own, once all the infection has gone out of it. No matter how much I soak the woven gauze packing before I put it inside the wound, it's sticking to my insides. Is there anything I can do so it won't stick? A tactic, a product that's safe for open wounds, anything?
I had a gastric stimulator implant that got infected. The surgeon removed it and left the wound open on my belly. It's about 4" long and 1.5" deep. I'm supposed to pack it with saline-soaked woven gauze and cover with non-woven gauze pads. When it sticks to my innards, it HURTS coming out. I'm tired of having to take pain medication for every dressing change (3x/day). Help me please?
I had a gastric stimulator implant that got infected. The surgeon removed it and left the wound open on my belly. It's about 4" long and 1.5" deep. I'm supposed to pack it with saline-soaked woven gauze and cover with non-woven gauze pads. When it sticks to my innards, it HURTS coming out. I'm tired of having to take pain medication for every dressing change (3x/day). Help me please?
Doesn't your hospital have a wound specialist?
posted by cda at 11:36 AM on October 25, 2023 [9 favorites]
posted by cda at 11:36 AM on October 25, 2023 [9 favorites]
Owwwwwwwwwwwwwwww agonizing sympathy pains, I hate this very much! Concur with fingersandtoes and cda on all but especially, please call the hospital and scream for help. It sounds just awful and I can't imagine there's a best-interests-of-the-patient reason why they thought it was no bigs to just send you off home to deal with this scary a level of pain and just... I-have-a-huge-open-hole-in-my-body-right-now-ness... all by yourself.
:(
I wish you every success and hope it gets much much better very very soon.
posted by Don Pepino at 11:40 AM on October 25, 2023 [4 favorites]
:(
I wish you every success and hope it gets much much better very very soon.
posted by Don Pepino at 11:40 AM on October 25, 2023 [4 favorites]
Definitely agree with others - please discuss this with your surgeon/medical team. You may also be able to find a wound care clinic in your area who could help and provide expert advice. It's really important that you get advice that's tailored to your specific wound and any other medical issues at play.
This type of dressing is called a wet-to-dry dressing. The drying out has a purpose - to pull dead tissue and drainage out of the wound - but yes, it REALLY hurts. (You're not doing something wrong! And having to medicate for these kinds of dressing changes is very normal.) My concern here is that if what that dressing is doing is important for your wound to heal, if you mess with that process by adding moisture or something else, it could significantly impair your healing. But maybe a wound care nurse or your surgeon might say that the wet-to-dry isn't necessary and/or could offer some alternative that would be easier to deal with.
posted by mandanza at 11:45 AM on October 25, 2023 [17 favorites]
This type of dressing is called a wet-to-dry dressing. The drying out has a purpose - to pull dead tissue and drainage out of the wound - but yes, it REALLY hurts. (You're not doing something wrong! And having to medicate for these kinds of dressing changes is very normal.) My concern here is that if what that dressing is doing is important for your wound to heal, if you mess with that process by adding moisture or something else, it could significantly impair your healing. But maybe a wound care nurse or your surgeon might say that the wet-to-dry isn't necessary and/or could offer some alternative that would be easier to deal with.
posted by mandanza at 11:45 AM on October 25, 2023 [17 favorites]
The drying out has a purpose - to pull dead tissue and drainage out of the wound - but yes, it REALLY hurts. (You're not doing something wrong! And having to medicate for these kinds of dressing changes is very normal.)
So from the original question it appears OP knew exactly none of that, which would indicate that OP's medical team left out some very basic information and instructions that OP really needed to handle this on their own and heal well. For people without a medical education whose wound-care experience is mostly "I skinned my knee/got a blister on my heel/cut my finger slicing onions," it's counterintuitive to think it would help a wound to heal to be constantly re-opening that wound and pulling stuff out of it. Not to mention, most humans and other animals learn in early life that a sharp increase in pain is a clear signal to STOP; what you're doing right now is GOING TO KILL YOU. If extreme pain is a good sign, that's not something the average person is going to just know. Rather, it is something you'd kind of need to be told, clearly and repeatedly, in written and spoken words, and preferably it should be back-and-forth communication where the patient repeats the instructions back so that the doctor/nurse can check that they've understood correctly.
This hospital needs to get feedback about this. The feedback should be immediate and loud, and it needs to be sustained until it is clear the hospital has heard it and acted upon it by discussing the problem with the surgical team who failed to tell their patient how to do wound care and what to expect.
posted by Don Pepino at 12:20 PM on October 25, 2023 [28 favorites]
So from the original question it appears OP knew exactly none of that, which would indicate that OP's medical team left out some very basic information and instructions that OP really needed to handle this on their own and heal well. For people without a medical education whose wound-care experience is mostly "I skinned my knee/got a blister on my heel/cut my finger slicing onions," it's counterintuitive to think it would help a wound to heal to be constantly re-opening that wound and pulling stuff out of it. Not to mention, most humans and other animals learn in early life that a sharp increase in pain is a clear signal to STOP; what you're doing right now is GOING TO KILL YOU. If extreme pain is a good sign, that's not something the average person is going to just know. Rather, it is something you'd kind of need to be told, clearly and repeatedly, in written and spoken words, and preferably it should be back-and-forth communication where the patient repeats the instructions back so that the doctor/nurse can check that they've understood correctly.
This hospital needs to get feedback about this. The feedback should be immediate and loud, and it needs to be sustained until it is clear the hospital has heard it and acted upon it by discussing the problem with the surgical team who failed to tell their patient how to do wound care and what to expect.
posted by Don Pepino at 12:20 PM on October 25, 2023 [28 favorites]
Your surgeon's office should be able to give you advice by phone, bring you in, or refer you to a wound care specialist nurse but in general, specialist packing strips (instead of plain standard gauze) won't cause the wound adhesion you're experiencing.
posted by DarlingBri at 12:28 PM on October 25, 2023
posted by DarlingBri at 12:28 PM on October 25, 2023
I had a colostomy reversal 40 days ago. The instructions were to make a small twist, put on a little saline and just barely put it past the skin line. The purpose was to get the wound to heal from the inside out, and not seal over and possibly cause infections in the hole. Given that you already had an infection, I'm thinking these were likely their thoughts. And if it did stick, it was painful.
Totally call them up, find a wound care nurse to give you better information, or even home visits. When I had much more greivious wounds last winter, it was great to have them come out and give me an expert opinion, rather than just Ms. Windo saying, "looks OK?"
Good Luck! Make your care team actually treat you!
posted by Windopaene at 12:51 PM on October 25, 2023 [5 favorites]
Totally call them up, find a wound care nurse to give you better information, or even home visits. When I had much more greivious wounds last winter, it was great to have them come out and give me an expert opinion, rather than just Ms. Windo saying, "looks OK?"
Good Luck! Make your care team actually treat you!
posted by Windopaene at 12:51 PM on October 25, 2023 [5 favorites]
This is horrible. I had a wound vaccuum after my c-section and I have a beautiful scar and did not have to deal with the things that you are. Perhaps ask for those? Throw a fit! Act like an entitled white male attorney.
posted by notjustthefish at 3:32 PM on October 25, 2023 [1 favorite]
posted by notjustthefish at 3:32 PM on October 25, 2023 [1 favorite]
I changed this type of dressing two times a day for months for a friend who was recovering from emergency bowel surgery and I am appalled and slightly horrified to learn that the changes should hurt and pull on the healing tissue. OP please speak directly to a wound care nurse and find out exactly how this is supposed to work for you.
posted by Vatnesine at 3:49 PM on October 25, 2023 [2 favorites]
posted by Vatnesine at 3:49 PM on October 25, 2023 [2 favorites]
Wound care specialist and professional advice for sure. I am not your ICU nurse, but I am etc etc: it's not uncommon for dressing changes to be uncomfortable, but the change frequency is usually often enough that the packing has not completely dried. If I was changing a dressing that was stuck, i would irrigate with sterile saline to loosen it.
There are better choices for packing than woven gauze, as described above. Please speak with someone familiar with your wound anatomy and concerns. You are correct that it should not be as painful as it sounds, though pain-free is unlikely.
posted by Pantengliopoli at 6:29 PM on October 25, 2023 [5 favorites]
There are better choices for packing than woven gauze, as described above. Please speak with someone familiar with your wound anatomy and concerns. You are correct that it should not be as painful as it sounds, though pain-free is unlikely.
posted by Pantengliopoli at 6:29 PM on October 25, 2023 [5 favorites]
100% agree with several MeFites above. What you describe is a standard wet-to-dry dressing, but if the orders are to change it yourself 3x/day? That's kind of a lot. Did they set you up with any follow-up care?
Concur that you would benefit from an appointment with a wound care specialist. This is typically someone in a department affiliated with a hospital: Wound Healing Center is a common name.
Am nurse, did home visits for a while with LOTS of wound care, and like Pantengliopoli above I would use more saline to re-moisten the gauze when removing it.
posted by shiny blue object at 7:55 PM on October 25, 2023 [4 favorites]
Concur that you would benefit from an appointment with a wound care specialist. This is typically someone in a department affiliated with a hospital: Wound Healing Center is a common name.
Am nurse, did home visits for a while with LOTS of wound care, and like Pantengliopoli above I would use more saline to re-moisten the gauze when removing it.
posted by shiny blue object at 7:55 PM on October 25, 2023 [4 favorites]
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without changing the materials used, is it possible that more frequent changes OR the application of additional saline solution, squirted from a clean bottle like this, could prevent the drying out which I assume is causing the sticking? Like, when it's time for a change, take off the outer dressings, then re-soak the inner dressings before peeling them away?
posted by fingersandtoes at 11:26 AM on October 25, 2023 [13 favorites]