My first wound and wound-vac change:

I had my first wound viewing and wound-vac change experience last week. It was quite possibly the most unbelievable thing I have ever seen. The female patient, in her early 40s, had a wound from her last cesarean 18 years ago that never healed. She had an 18 yr old wound! She weighs over 300lbs and has type II diabetes, both of which have compromised her ability to heal the wound. She has seen several doctors about it over the years, as it would get infected, get worse, then treated, get better, then worse, etc. But it has never fully closed. Thus, the surgeons at High Point decided operate on her last week. They basically cut open her abdomen from hip to hip (and mind you, on a 300lb individual, that is a very large/long incision) and removed an incredibly amount of infected tissues (I think there was more there that was infected than they were expecting). They basically removed everything they could down to her organs.

Before going into the room, the wound nurse cautioned me that this is a very large wound and it could be a difficult one to see as a first. I braced myself as we entered the room, but nothing could have prepared me for the way it looked. In all honesty, it was more fascinating and very surreal than anything. This woman's stomach, from hip to hip, was completely open and exposed. Even more incredible is that she was in very little pain considering her condition and that, if all goes well, the wound would be completely heal in 3 months! The whole concept of a wound vac I also found intriguing; I mean, who thought of stuffing a wound full of foam, sealing it up, and sucking the air out?! Kind of crazy, if you ask me, even knowing that it encourages tissue to regrow. Still.... kind of crazy!

Although not in great comfort, it was good to see the patient in high spirits despite her condition and all that was going on. Still, I cannot help but wonder about her ability to heal this wound, now even larger, since she was not able to heal the original wound. Obviously, she now has more careful care and more people involved in helping her to heal this wound. But if she is unable to keep her blood sugars under control and continues to be protein malnourished while at home, how will this wound ever completely close?