Grafts Look Good, Trach Tube Out

Heather had her wound dressing change this morning at about 8:00am. The doctor said that the grafts on her legs look really good and seem to be progressing as he would hope and expect them to. The wound on her abdomen looks really good too. It has closed in significantly and seems to be healing really well. The doctor also said that she could get her tracheostomy tube out. He and ne of the residents came in a couple of hours after the dressing change and took it out. They put a piece of gauze over the hole and taped over it to seal it. It bubbles up a bit every time she breathes or tries to talk. They said the hole should seal closed on its own in anywhere from a few hours to two days.

After they finished dressing her legs the pain began. They had to change the dressing on her back where the skin was taken for the grafts. This is definitely the source of most of her pain. Despite the nurses best efforts to give her plenty of pain medications to prepare her for this dressing change, it was excruciating for her. I got to see the donor sites for the first time, and they are much larger than I had thought. It appears that they took four strips of skin off her back, each approximately 3"-4" wide and 12"-18" long. So, basically the entire surface of her back is one large sore. They only went deep enough to take the top layers of skin. So, it is not a bloody, red open wound, but rather it looks like a bad scrape all down her back. They had to wash it all and peal off the old dressing. This was quite painful. The most painful part of the dressing change involved an area low on her back where the original dressing has shifted up. This left the lower part of her wound exposed, and the diaper they have her on stuck to the wound. It was terribly painful to pull this off of her skin.

The new dressing they put on seemed to cause more pain than taking the old one off did. It is a special dressing lined with silver that has antimicrobial properties. This dressing can stay on until the wound is healed. This is a real blessing because it means that she won't have to go through daily wound dressing changes on her back that would be necessary otherwise. However, for a small percentage of people this dressing burns for 10-30 minutes when it is first put on. Of course, Heather falls in that small percentage. She was in significant, almost unbearable pain for about an hour after the dressing change and then has gradually been able to experience some relief in the time since. They gave her tons of different pain killers, trying to help her feel better, but nothing seemed to work at first. She seems much more comfortable now, and is sleeping.

We hope she won't have to go through any of that again. I hate to see her hurt. I'm excited about her progress though. Thank you for your prayers in her behalf.