f. Follow up Care.
(1) Initial patient education. Care the day of surgery entails advising the
patient that the initial dressing should be left in place until the next day. Also tell him to
elevate the affected extremity and that analgesics are seldom necessary. The day after
surgery, the patient should remove the external dressing but leave the packing in place.
He should soak the site in warm water compresses or take a tub bath for 20 to 30
minutes. The site should be submerged during soaks. A sterile dressing should be
reapplied after each soak.
CAUTION: If the packing falls out, DO NOT reinsert it!
(2) Follow up: health care provider. Reevaluate the patient 36 to 48 hours
after the incision and drainage procedure has been done. Wound care at this point
includes the following steps:
(a) Remove the external dressing.
(b) Gently remove the packing from the I & D cavity.
(c) Cleanse the abscess cavity with a cotton-tipped applicator soaked
in hydrogen peroxide. Anesthesia is not necessary.
(d) DO NOT repack the cavity, especially if it is clean and pain and
tenderness have significantly diminished.
(e) Reapply a sterile gauze dressing to the open wound site.
(3)
Follow up: patient education.
(a) Instruct the patient to continue soaks three to four times daily.
(b)
Continue these soaks for five to seven days or until the incision has
healed.
(c) If the abscess was adequately drained, the I & D will close
spontaneously by secondary intention within five to seven days post-procedure.
(Wound healing by secondary intention depends on the size of the wound. A small
puncture wound may heal in seven days. A wound that requires packing may take
three weeks or longer to heal.)
NOTE:
Remind the patient to remove the dressing before each soaking, to pat the
area dry, and to reapply the dressing.
MD0574
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