Author: Jo Hoefl ok RN, BSN, MA, CETN(C), CGN(C), Advanced Practice Nurse, St. Michael’s Hospital, 416-864-5112
This case study examines the use of Eakin Cohesive® to protect the skin around an upper transverse abdominal wound with Penrose drains.
Patient history:
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56 year old male with gallstone pancreatitis
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Required necrosectomy for control of sepsis
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Resulting upper transverse abdominal wound (Chevron incision) with Penrose drains
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Goals of care achieved with troughing: protect the skin, control drainage & odor, facilitate patient comfort and ease of nursing care.
SuppliesSupplies used:
Application:
Step 1: Penrose drains at apex and left lateral side of wound
Step 2: Begin building trough at one lateral end of wound, moving towards apex of wound. Pieces should overlap by 2-3 cm
Step 3: Apply bead of paste to inner edge of barrier sheet, cover surface with overlapping pieces of thin film
Step 4: Cut hole in most lateral end of trough, sufficient to allow for drainage of effluent
Step 5: Cut hole in pouch to the largest possible size and apply bead of paste at inner edge
Step 6: Apply pouch over opening in trough
Step 8
Step 7Step 7: Begin building trough at alternate end of incision, again with overlapping pieces and building toward apex of wound
Step 8: Complete bead of paste at inner edge and cover remainder of trough with thin film
Step 10
Step 9Step 9: Cut hole in trough over Penrose sites and apply 1-piece pouch
Step 10: Patient must remain flat for 20-30 minutes post-application