LEC 2: Acute Surgical Wounds

Question 1

Wound Staple Removal

Answer 1

• Clean incision Remove alternate staples; then remaining
• Cleanse incision after
• Can use steristrips/ skin closures
• Use REEDA to assess the wound

Question 2

Suture Removal

Answer 2

• Clean incision
• Grasp knot with forceps and use suture cutter or scissors to cut suture at skin’s surface, opposite the knotted end
• Remove alternate sutures; then remaining
• Cleanse incision after
• Can use steristrips/ skin closures
• Use REEDA to assess the wound

Question 3

How do you irrigate a wound?

Answer 3

1. Pour ordered solution into sterile irrigation container
2. Fill a syringe with solution and gently allow solution to flow over wound
3. Continue until the irrigation flow is clear
4. Dry surrounding area

Question 4

How do you do if there is solution in the wound after irrigating it?

Answer 4

Use a sterile gauze to soak up the excess solution

Question 5

How do you pack a wound?

Answer 5

Moisten sterile gauze with sterile water and fluff gauze while placing it in the wound

Question 6

What does packing a wound promote?

Answer 6

Promotes healing from the bottom up

Question 7

Montgomery Ties

Answer 7

Adhesive ties (tape) affixed to the skin so as to provide a method of securing a bandage and subsequently changing it without having to replace the tape each time. Most often used for abdominal incisions but still requiring frequent dressing changes.

Question 8

What are key components for documentation regarding wound drains?

Answer 8

• How many drains are there
• What type of drain(s)
• Colour and amount of drainage
• Where is the drain(s) located on the body
• What does the drain site look like

Question 9

What are the different types of wound drains?

Answer 9

• Pinrose Drain
• Jackson-Pratt (JP) Drain
• Hemovac Drain
• Vacumm Assisted Closure (VAC) Drain

Question 10

Pinrose Drain

Answer 10

• Lies uder a dressing
• A pin or clip is placed through the drain to prevent it from slipping further into a wound
• Allows the drainage to passively flow through the body
• Change the dressing around the drain carefully to not pull it out

Question 11

Jackson-Pratt (JP) Drain

Answer 11

• Allows for drainage to be collected internally and is expelled by suction
• Need to empty if you see drainage It is painful when removed
• When you remove the JP, want to make sure the end is still in-tacked

Question 12

Hemovac Drains

Answer 12

• Accommodates a larger volume of fluid or drainage; 400 to 500 mL
• If folly is extended, need to empty and then compress
• Always make sure tip is in-tacked when pulling out a drain

Question 13

Vacuum Assisted Closure (VAC)

Answer 13

• Used for negative pressure wounds
• Helps keep wound together
• Promotes cellular regeneration
• Need to change every 4 to 5 days

Question 14

Key Commpents for Documentation

Answer 14

• What did you do and why
• Pain assessment: pre/inte/ post
• Dressing removal description
• What did you do to the wound
• Wound assessment (REEDA or MEASURE)
• Drain present, location, cleansed
• Did you do anything else
• Dressing application description
• Patient tolerance