Wound care assessment
Instructed patient about vacuum assisted closure ( VAC ) therapy as it promotes wound healing through negative pressure wound therapy.
Instructed patient through the use of negative pressure wound therapy, a standard surgical drain, and optimized nutrition, fistula drainage was redirected and the abdominal wound healed, leaving a drain controlled enterocutaneous fistula. Patient control of fistula drainage and protection of surrounding tissue and skin is a principle of early fistula management.
Instructed patient abour the V.A.C. therapy System is an Advanced Wound Therapy System consisting of a V.A.C. Therapy unit that delivers negative pressure and a sterile plastic tubing with SensaT.R.A.C, pressure sensing lumens that connect the therapy unit to the dressing Special foam dressings. KCI recommends the V.A.C. Dressings be changed every 48 to 72 hours, but no less than 3 times per week. Patient has the ability to move around depending on the condition, the wound location and type of therapy unit prescribed. The V.A.C. Therapy System may be disconnected so you can take a shower. Therapy may not be off any longer than two hours per day.
SN instructed patient and caregiver to eat a healthy diet, as it can boost your immune system and speed up wound recovery. Five nutrients that are essential for wound healing: Protein, Vitamin C, Zinc, Carbohydrates, Vitamin A
SN instructed patient on nutrients required for wound healing. To promote wound healing with good nutrition, plan healthy, balanced meals and snacks that include the right amount of foods from 5 food groups: protein, fruits, vegetables, dairy and grains. Fats and oils should be used sparingly. Choose vegetables and fruits rich in vitamin c, such as strawberries or spinach. For adequate zinc, choose whole grains and consume protein, such as eggs, meat, dairy or seafood. Some wounds may require a higher intake of certain vitamins and minerals to support healing. Include adequate protein throughout the day. Include a source of protein at each meal or snack. Stay well-hydrated with water or other unsweetened beverages. For people with diabetes, monitor, and control blood sugar levels to help prevent new wounds from developing and to support healing and recovery. Patient verbalized understanding.
Patient was instructed on how to prevent pressure ulcer. A proper skin care is crucial and involves inspecting skin daily and an individualized bathing schedule, using warm (not hot) water and mild soap. Avoid massage over bony prominences and use lubricants if skin is dry.
Taught the patient how to care of wound and dressing changes. The patient was instructed to care for drains if he/she was discharged with them. The patient was advised to avoid lifting anything over 10 pounds for the first 6 weeks.
Instructed patient consider nutritional supplementation/support for nutritionally
consistent with overall goals of care.
Instructed patient reposition bed-bound persons at least every two hours and chair-bound persons every hour consistent
with overall goals of care.
Instructed caregiver inspect patient's feet every day—especially the sole and between the toes—for cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality. Each time you visit a health-care provider, remove your shoes and socks so your feet can be examined. Any problems that are discovered should be reported to patient's podiatrist as soon as possible; no matter how simple they may seem to you.