Abdominal drains are silicone tubes placed in the abdominal cavity by surgeons according to the needs of surgery, the purpose of which is to drain the seepage of fluid and blood from the abdominal cavity out of the body and reduce the absorption of toxins. At the same time, it can help doctors analyze the condition and observe whether there is anastomotic fistula or bleeding according to the color, nature and amount of the drainage fluid.
Therefore, the care of abdominal drainage tubes is very important. If intra-abdominal exudate leaks out from around the mouth of the drainage tube, the moist dressing will reduce the patient's comfort, and frequent dressing changes will increase the workload of healthcare workers.
Wound exudates are usually alkaline mucus with a pH of 7.6-8.4. These exudates can cause continuous skin irritation, aggravate patient's pain, delay healing time, and increase patient's healthcare costs.
In the past, in the face of wound exudate, we are passive to change the medicine when there is exudate, and change the gown and bed sheet when the gown is wet. This not only increased the patient's discomfort, but also increased the workload of nurses.
In addition when changing medication, taping and tearing off the tape may also cause new injuries to the patient's skin, and in severe cases, skin lacerations - nursing adverse events.
So, is it possible to achieve the challenge of preventing fluid leakage from the drain opening by improving the ostomy bag?
First, I explained and communicated well with the patient and his family, and taught them the precautions for observing and using the ostomy bag, and finally began the operation.
Prepare the required items: one disposable ostomy bag, saline, povidone-iodine disinfectant, 7# mousse thread, and dressing change kit.
Disinfect and clean the wound with iodophor disinfectant and saline, and leave it to dry.
For general patients with drainage tubes and single small wounds, the center caliber of the ostomy bag is directly aligned with the drainage tube or wound without additional cutting. For multiple wounds in close proximity or a single large wound, the caliber of the ostomy bag can be cut and then applied around the wound.
If there is a drain, pass the drain through the center caliber of the ostomy bag and cut the cross shape of the other side of the clear pouch against the center caliber to allow the drain to exit through the center. Then tie the small gap between the bag and the drain tube with 7# mousse thread. Finally, clip the ostomy bag closed. The wound exudate can then be collected into the bag.
Note that the upper cross-shaped cut is as small as possible, not too large, and the direction of the ostomy bag is the same as the direction of drainage tube drainage. In case of post extubation exudate, sterilizing the stoma bag and sticking it firmly will be enough.
We apply the ostomy bag to the management of exudate, which is conducive to more accurate observation and statistics of the changes in color, character and volume of exudate. Not only does the ostomy bag separate the exudate from the surrounding skin, but the hydrocolloid dressing in the ostomy bag's sump also protects and repairs the skin.
The question is bound to arise as to whether ostomy bags increase the cost to the patient; this is not the case.
Moreover, if the ostomy bag is properly fixed and maintained regularly, it can usually be used for a week. This will cost the patient even less.