Infection and Drainage

I don't think I've written about this before. On Tuesday, when they took off the wound vacuum pump, the docs noted the smell and that I had a pseudomoniasis infection. I guess it's not all that uncommon, especially since I've seen hints of pseudomonasis in the wound off and on (maybe 5 times) in the last six months.

So, while the wound/skin graft is healing under my armpit, the whole area needs to be cleaned with Dakins solution (partly bleach) for a few days. We started this yesterday morning. I was supposed to change the dressing last night but after the trauma of the trip home and one of the interns inadvertently ripping (well, it wasn't quite that bad, but he could've been more gentle) part of the dressing off the skin graft donor site on my thigh, I knew I couldn't face seeing the wound.

I finally got my courage up and changed it this morning. In a way, it's a bit ridiculous to think that I can do it because I really can only use one hand since the other one is lifting my arm up. I also didn't want my family to change it - my sister maybe, but I really didn't want anyone else to see it. Hell, I don't want to see it. But I saw it this morning and the sight affected me. The defect is larger than I thought. I had visions of it being all almost normal, but that's not the case. There's an area of maybe 3-4 inches long and a few inches wide that is about 1/2 inch lower than the rest of my skin. The docs never told me what to expect and I didn't ask.

Anyway, I'm in the process of wrapping my head around the sight of the site. I keep remembering that they were able to get all the cancer. The surgeon said all the margins were clear of cancer. And, that's good.

The wound care nurse thinks that the graft will grow over some of that defect. We will see in time.

I am so glad I saw the the wound care nurse today. She changed the dressing in my armpit - made sure it was clean. She put the Dakins on it and wrapped it all up again.

L. (the wound care nurse) also changed the dressing around the JP drain site. There was a bit of pseudomoniasis around that area, too, so she again cleaned it and put a new dressing on it.

Then, it was time to tackle the donor site on my left thigh. I was not looking forward to it because I knew the dressings were already sticking to the new skin. It's like ripping off a scab to a big strawberry you get from sliding in softball. Anyway, L was gentle again. She cleaned the whole area because there was a hint of pseudomoniasis in the donor site as well. She took off the whole old dressing, then put collagen over the donor site, covered it with oil emulsion dressings (which will NOT stick), then transparent plastic. The whole thing is wrapped in an ace bandage.

So, I have a few sites of drainage. TWo places under my armpit. One by the JP drains, and the donor site. All were leaking onto my clothes. As L. said, if it's leaking, then it's easy enough for bacteria to get in to colonize an area.

In the meantime, she also took my temperature - it was 100.2. I took it again when I got home - it was 99.7. So, I have a low grade fever, probably a reflection of the skin infection.

I am on antibiotics for the next week - maybe two. Hopefully, this will take care of the infection both inside and out.

I feel so much better that L. took care of me. In the end, I have more confidence in her skills to keep infection away than what I witnessed at OHSU in terms of how they take care of wounds. I now have all new dressings. I'm confident the wounds are as clean as possible. And, I don't think I will leak.

It's for those reasons that I still don't really feel like going out in public. I feel too . . . ugly with leaking drains, a bit of an odor, and JP tubes sticking out. Plus, I am tired. It's good to rest, eh?