Hi all I am at home recovering from seton placement for fistula and abscess draining same abscess as September.. Not very deep cut surgeon said maybe one day of packing but yesterday thought it should be longer..The home care nurse said it shouldn't be packed everyday? It was in September and never fully healed so what is the right thing to do? Any studies or material on packing or not? I am just confused and my packing falls out anyways no matter what they do to try to keep in on.. I just keep getting in the tub after a bowel movement to try and keep the area clean..
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780182/
This study showed no difference in healing time, and less discomfort with packing.
Here's the segment:
The Role of Packing of the Abscess Cavity
"Packing of the abscess cavity is a common, but usually unnecessary, practice following incision and drainage. Packing may be beneficial at the time of abscess drainage by providing hemostasis of the inflamed, hypervascular abscess cavity. A well-drained abscess cavity rarely requires débridement or gauze to prevent premature closure of the skin. In a small randomized trial Tonkin et al compared packing with no packing of perirectal abscess cavities.11 They demonstrated similar healing, recurrence, and fistula rates and also showed that the pain scores tended to be lower in patients who did not have packing. Routine wound packing results in discomfort and additional expense to the patient and is probably unnecessary."
This study showed no difference in healing time, and less discomfort with packing.
Here's the segment:
The Role of Packing of the Abscess Cavity
"Packing of the abscess cavity is a common, but usually unnecessary, practice following incision and drainage. Packing may be beneficial at the time of abscess drainage by providing hemostasis of the inflamed, hypervascular abscess cavity. A well-drained abscess cavity rarely requires débridement or gauze to prevent premature closure of the skin. In a small randomized trial Tonkin et al compared packing with no packing of perirectal abscess cavities.11 They demonstrated similar healing, recurrence, and fistula rates and also showed that the pain scores tended to be lower in patients who did not have packing. Routine wound packing results in discomfort and additional expense to the patient and is probably unnecessary."
I had a home health nurse and she was not as knowledgeable about things as my surgeon was. I knew when I started asking her things and she would give me the answer "well you shouldn't have to" or "I wouldn't if I were you". I would advise you trust your surgeon in what him or her directs you to do since this is their expertise and they deal with this stuff everyday. I don't think a lot of these home health nurses deal with a lot of jpouch patients. It seemed like my home health nurse's expertise was taking my vitals and blood that's about it.