Postoperative Wound Care

The diseased area resulting from recurrent relapses of abscesses and chronic inflammation is delineated with ink. Following cleansing with 0.05 mg/ml chlorhexidine solution the area is anesthetized with injections of lidocaine (0.51.0 mg/ml) and epinephrine (Xylocaine® adrenalin, Astra, Sodertalje, Sweden) with sufficient margins. Richly innervated areas, such as the groin, are pretreated with a lidocaine/prilocaine cream (EMLA®, Astra) prior to the injections. The solution is injected and infiltrates around and not directly into the affected site, forming a square around the area, thus avoiding direct contact with inflamed tissue as well as injection into the abscess itself, thereby preventing an increase of pressure and pain or eruption of purulent discharge. This procedure leads to almost complete anesthesia within 5-10 min. Recently we have started to use highly diluted local anesthetics in large volumes, the tumescens method. When larger areas require treatment,

Immediately after the wounds are surgically dressed, the patients are instructed to stand up and take a short walk. The patients remain at the clinic for 3 h following the procedure, which allows them to check for functional impairment and gives them the opportunity to empty their bowels and bladder and also to discover any bleeding before leaving. The dressings are initially left on for 2-3 days without being changed, to avoid early bleeding. Thereafter, the wound is cleansed and rinsed with tap water and the bandage changed as often as necessary, sometimes on a daily basis, until complete healing is accomplished. Since 1998 a hydrofibre dressing (Aquacel®, ConvaTec, Deeside, UK) has been used for this purpose. Usually the patient does this procedure without any need for medical professional assistance. In our experience the pain felt during wound care when changing the dressings is the most problematic event for patients in the postoperative period. In our opinion the hydrofibre bandage is less painful to remove than previously used dry dressings or ointment-impregnated dressings, although this has yet to be studied in a controlled manner. Analgesic requirements are controlled with standard doses of paracetamol. Antibiotics are used if clinical signs of secondary infection are found. The patients are followed-up for a wound check after 1 week and subsequently if there are signs of complications until they are healed; they are then followed-up at 6 weeks and at 6 months, and thereafter only when there are complications or other clinical reasons for medical intervention.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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