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Poster introduces nursing problems we faced nursing of 35 years old male that was urgently operating after the perforation of bowel diverticulum. The operating surgeon performed a partial resection of sigma and creates a temporarily reliving ileostomy. Few days after the operation dehiscence of laparotomy wound occurred and MRSA infection was confirmed.
In managing this case we want to point out three complex nursing problems. Each of them separately is a challenge for nurse, handling all together demand serious nursing involvement.
Ileostomy was created in skin fold in the distal part of the abdomen very near the extensive surgical wound and hip. Because of bed location, surface that is not in the same level and small area, placing of ostomy appliance was obstructing. Together with constant elimination of liquid stool this results in often drops of skin barrier. Because of this reasons and considering the need to relive the bowel the patients was on parenteral feeding for longer period.
Dehisced laparotomy wound a few days after surgery represents a different problem that is solvewith negative pressure therapy. The purpose of this treatment is drainage and the removal of infective material, and other fluids under the influence of negative pressure. Afterwards when secretion decreases we successfully used hydrofibre dressings for the same reasons.
Hospital infection with MRSA didn’t affect this patient specially. But to prevent spreading all necessary measures were performed. The patient was isolated, protecting clothing was used, and strict regime was carried out for visitors, especially hand washing. Special attention was dedicated to managing the wound and stoma.
Step by step poster uncovers management of described nursing problems and as a result of one year’s work fully recovered patients can confirm success of our proceedings.