rectal packing falling out

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sammies
Regular Member


Date Joined Feb 2008
Total Posts : 493
   Posted 3/13/2009 3:28 PM (GMT -7)   
Should I be upset? The visting nurses have been packing my rectal opening with saline and gauze--everyday this week so 5 times. Unfortunately, it falls out a few hours later. While my husband has watched them do it, he's still not comfortable replacing it--needs a few more times watching the nurse. They told me not to look at the wound in the mirror and he's said it's pretty darn big and cavernous. If the packing stays in only just for a few hours, will I heal wrong? Should I be bugging the nurses and getting them back out here?

I am going to ask about the wound vac as gladbag suggested.
24+ years with Crohn's/colitis; fistulizing crohn's; ileostomy and proctocolectomy; propranolol and xanax; been on a ton of crohn's meds; praying to get through each day.


flchurchlady
Veteran Member


Date Joined Jul 2007
Total Posts : 2765
   Posted 3/13/2009 5:18 PM (GMT -7)   

There are two things the nurse can do to keep the packing in. She can put tape over the gauze to keep it from falling out and use smaller pieces of gauze. As the wound heals, the pieces of gauze will get smaller. You'll go from 4" x 4" squares to 2" x 2" squares to 1" strips on down.

Have you looked at it in a mirror yet? I didn't mind looking at it, so I packed it myself while bending over in front of a long mirror. I would pack it in the morning and then again at night before going to bed.

If the packing falls out, it can decrease the healing process and increase the chance of infection, so it is important to keep it in.


Cecilia
Dx'd Crohn's in '99 at 28. Proctocolectomy and ileostomy in '06.
Disease-free, medicine-free, and very thankful to be healthy again.


2 RIS K
Regular Member


Date Joined Aug 2008
Total Posts : 367
   Posted 3/13/2009 5:24 PM (GMT -7)   
I don't have a permanent ileostomy, but just out of curiosity why do they have to do that to your butt? why can't they just leave it alone like with a temp ileo? i'm just curious.
Amanda
35 years old
Chronic Lifetime Constipation
Diagnosed IBS - 1995
Rectal Prolapse - February 2007
Rectosigmoid Colectomy w/low anterior Anastomosis - March 13, 2007
Diagnosed with Colonic Inertia - June 08
Total Colectomy - September 22, 2008
Temporary Ileostomy due to small bowell perforation Septepmber 29, 2008
Ileostomy Reversal - December 15, 2008
Multiple Small Bowel Abscesses-December 22, 2008
Leak at original Anastamosis -December 25, 2008
JP Drain removed - January 23, 2009
 
The whole world is at your feet; so paint your toenails Red!
 


flchurchlady
Veteran Member


Date Joined Jul 2007
Total Posts : 2765
   Posted 3/13/2009 5:33 PM (GMT -7)   
With a proctocolectomy, they remove the rectum, too. If they leave the wound open, it has to be packed with saline filled gauze so it can heal slowly from the inside out.


Cecilia
Dx'd Crohn's in '99 at 28. Proctocolectomy and ileostomy in '06.
Disease-free, medicine-free, and very thankful to be healthy again.


Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 3/13/2009 6:09 PM (GMT -7)   

If you can go the wound vac route, I'd suggest it...I used mine for 14 days (all I could get out of my insurance) and it cut my healing time in half (my wound was more than 5cm deep into my pelvis and about the same lengthwise).  Like Cecilia said, the gauze has to stay in or you could end up with a pocket of infection that you'll have to go back into the OR for...then start the packing all over again.

I also packed mine myself (morning/noon/nite) by putting a large hand held mirror on the toilet and standing over it.  Why won't they let you look at it?

Call your nurse back in to take care of it and have her/him tape a 4x4 over it...you can at least change the 4x4 if needed...

Post Edited (OHIO76) : 3/13/2009 7:18:32 PM (GMT-6)


sammies
Regular Member


Date Joined Feb 2008
Total Posts : 493
   Posted 3/14/2009 8:19 AM (GMT -7)   
I asked the Visiting Nurse to tape the packing in today and she did. I'm trying to be a little more low key today too--that should help. Enjoying a book on the couch while getting some of my physical therapy butt and thigh squeezes in.

The wound is 10cm by 6 cm and I'm of a small frame and 5' 2". It's a big wound for me I am told. I asked about packing it myself--she said maybe in a a few weeks when my abdomen heals and the swelling in my legs goes down but for now I shouldn't be twisting or turning to try to do it.

I really appreciate the reassurance and the help!!
24+ years with Crohn's/colitis; fistulizing crohn's; ileostomy and proctocolectomy; propranolol and xanax; been on a ton of crohn's meds; praying to get through each day.


flchurchlady
Veteran Member


Date Joined Jul 2007
Total Posts : 2765
   Posted 3/14/2009 1:17 PM (GMT -7)   
Glad we could help! :-)
Cecilia
Dx'd Crohn's in '99 at 28. Proctocolectomy and ileostomy in '06.
Disease-free, medicine-free, and very thankful to be healthy again.

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