Skin / Capillaries look dead to surgeon

Good Morning-friends, have been working on an issue with a member. Wanted to share with you all the note below b/c of it's importance. Hope you find it useful Sassy

(members name deleted) Glad the link helped. If you get the AARP magazine this months issue (probably dated may 2013) , there is a story about the safest hospitals and what safety procedures that are in place that cause them to be safe. The article cites that 180,000 people die a year due to medical/surgical errors AND 400,000 drug errors are made a year. The articles states that these numbers are likely higher b/c these are the ones that are reported. I agree. I know you've seen where I've said on the threads "Sorry etc for too much info, just want too make you(BCO memebers) safer". Guess I should stop apologizing for writing stuff in this regard. These numbers are higher then the last set of numbers that I had known. The problem is either getting worse OR there is better reporting. I'll go with better reporting.

It cited that one of the safety items was having an ICU Intensivist. It cited that only 35% of hospitals had Intensivist. I was dismayed at this percentage since residencies for Critical Care Medicine have been available since the 1980's. Truly thought by now that the "industry" would have been driven by demand for better care that this statistic would be 70 to 80%. ICU medicine is absolutely in need of a specially trained doc. Just as in all subspecialties of the American Medical Association(AMA), the knowledge and skills of this subspecialty are critical to survival when a patient is at this level of need.

I'm going to post this on the threads, I'll take off identifiers. My hope is those seeing this will locate a copy of the AARP article. Read it throroughly. Then question there local hospitals on each item. Based on what they elicit re:safety of each facility, they can choose the safest hospital near them for care. It can mean the difference between life and death, and or avoidable complications. Spreading the word to others regarding this may save lives.

Your description of where your friends daughter is now is typical. So, the care may have been fine or she recovered in spite of them. I'll go with the care b/c of your description of how she appears now. What was truly lacking here was the communication in lay terms to the family of was what was going on with the patient. All the lay person then can do observing is assume, as in this patients case, there appeared to be fractured care delivery and choas. What can the untrained person concluded observing this. As in all care, communication is the center of it all. Very often even the care givers question what the recovery will be. AND then the patient pulls through. Continuing with evaluating the records will lend a lot to the understanding of this event.

Thanks for bringing this thread to my attention, Sas.  Wish I'd seen it before last week since there was an open wound with HH involved.  Regardless, it's been seriously helpful and today is the post-op appt after Friday's surgery.

The most interesting part was about a wound that has leakage - surgery last month had the leakage since no drain was used.  So it set things up for the capsulated seroma that happened. 

This time there is a drain although the output has been minimal.

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Hi reposting this on some threads, may be old news to some, but to good of info not to pass this on,Sassy

Bluebird144…NJJoined: Apr 2013Posts: 393

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Bump, particular useful things here are wound care

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MTG 1953------Please, call your doc. Try and read from the beginning . This is only a few pages. Skim for wound evaluation and care management. If you post here PM and say "HEY YOU----take a look at skin and caps thread."

Once you get docs recommendations post them and I'll help you through best I can. 

The rads threads gals may have some suggestions.

Something sounds out of whack. Seems an unusually severe response  for this early in rads. Plus, more like a response expected years and years ago. Allot has been learned on how to limit such burning.

Keeping it covered with a dry sterile(if possible) dressing until you get definitive directions from doc is a good approach. Loosing the skin is a setup for infection. Protecting the wound and serious hand washing when doing dressing changes. No sneezing or coughing over wound. Again there are so many suggestions on the previous several pages. Try skimming first. No sense in reinventing the wheel. Sassy

MTG_ YAY your done. I just posted a PM to you answering your PM. I didn't come here first. OH what a relief it is to be done --another YAY!.

PM  with editing -"There are dressing materials that really help prevent wound infection. There are a couple of approaches. You could ask your doc if you could have a referral to a 1.wound care center. 2.home care nurse. 3.burn center outpatient wound care. 

With the three types of centers, I can give you the pro and con of each.

Give me a call if you can.

Please, read the section on the skin and cap thread where I describe how to set up a wound care station, washing, and dressing changes. Should be page one

I'm going to cut& paste this too skin and cap thread. Good Luck, sassy"

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This is reposted with Marlanab's permission. She, also, posted it on the LE thread.

"posted by Marlanab-----a couple of weeks after my surgery, I developed a seroma in my arm pit and started having lymphedema issues in my arm and wrist. I tried some of the exercises and nothing worked until one day at work I started just flexing my pec muscles repeatedly. The swelling was gone within days. My guess is that since the lymph nodes that I had removed were gone, moving the muscle helped move the fluid out. I was an athletic trainer for 8 years through high school and college so I kind of used my knowledge of anatomy and experience dealing with injury management combined with common sense given that the most of the lymph nodes I'm missing are along the lateral (outer) side of my right pec muscle. The pectoralis major muscle inserts right along the armpit where my seroma had formed so it made sense to flex that muscle to get the remainder of my lymph nodes working to get the fluid out. I don't know that this would work for everyone given that my lymphedema was only present when my seroma was at it's most swollen. When the seroma went down, so did the lymphedema in my arm. "

This is to a link that marlanab wrote a more extensive description of her pec technique. She also answered deveral questions regarding this technique.

https://community.breastcancer.org/forum/64/topic/830471?page=1#idx_29

Link to a rads thread. Please, try to review from the begin. Oodles of info.

https://community.breastcancer.org/forum/70/topic/783321?page=18