A primary closure technique is used; that is, the edges of the wound are closely approximated, thus eliminating dead space and involving minimal formation of granulation tissue, and a drain is inserted. What is the purpose of wound drainage for Mr North?
John North, 53, has a history of type I diabetes mellitus, cigarette smoking (40 pack years), coronary artery disease (CAD) and peripheral vascular disease (PVD). Six weeks ago, he developed a wound on his left heel that measured 4 cm by 2 cm. Despite IV antibiotics and chemical debridement, the wound developed a gangrene infection. He is scheduled for a below knee amputation (BKA) of the left lower extremity tomorrow at 10 am. His meds include daily insulin, aspirin 325 mg/day and Pletal (cilostazol) 100 mg b.i.d. He has an advanced directive and no known drug allergies (NKDA).
What will be an ideal response?
Answer:
The purpose of wound drainage for Mr North is to reduce the possibility of a postoperative haematoma. The use of a suction-drainage (negative-pressure bottle) helps avoid tissue destruction, painful distension and the reduces the medium for growth of bacteria.
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