My daughter had an abdominal operation 9 weeks ago. There was problems with the wound getting infected so part of it was opened up and then nurses packed it with gauze daily to help it heal. My daughter has been having this done daily ever since but has been told today the wounds are still over 4 cm deep and have barely improved over the last 6 weeks.

Obviously my daughter is extremely fed up about this as it is causing problems as she is not supposed to pick up her 3 month old baby, can't have a bath and is fed up with ooze from the wounds soaking her clothes. 

She has been told that one of the reasons that the wounds are not healing is because she walks down to the doctors surgery every day with the baby, a distance of 1.5 miles each way. and the nurses have advised her to stop doing this. Not quite sure how they expect her to get there as they don't have a car, the bus route would mean a journey of over half an hour each way changing buses on the way and would mean lugging baby and pushchair on and off the bus. They won't give my daughter a regular appointment each day. Appointments are only booked a couple of days in advance and can be any time of the day making it impossible for me to schedule my job round them to give her a lift and even if they gave her regular appointments I  would not be able to take her every day as I sometimes work in other areas. She has asked if she can have a nurse to visit her at home but has been refused as she is mobile.

As there are some nurses on the board just wondering if anyone can suggest anything she can do to help the wounds heal? Is there any treatment apart from the continual packing with dressing that she could ask about. Thanks very much for any help.

edited to add, the wound has been swabbed several times since and there is no infection there at the moment.

I had the same problem many years ago and it was suggested to me by the nurse to remove the packing myself, just before it was due to be re dressed, and have a salt bath.

I know things change over time so not sure if it would still be recommended.

Perhaps someone in the know will know!

It'd be worth mentioning Manuka honey and/or silver bandages to the nurses.

Does she have another appointment with the surgeon or has she been discharged ?

Is she eating well as diet is very important when it comes to healing, a daily garlic capsule will boost her immune system to fight infection.

She is doing more exercise than is advisable and to cut down she needs to take a taxi at least one way if there is no other option. After all this time she needs to go back to the consultant who did the surgery and get the cavity cleaned out and resutured, all packing with gauze does is soak up the leakage and stop the surace healing over, there used to be sponge products available that were poured into the hole and took up the shape, the sponge was removed regularly,rinsed out and replaced, the patient or family member was able to do it with training, as the cavity shrunk it would squash the sponge, eventually a new sponge would be needed, using this technique stopped any risk of injury from poking gauze blindly into a hole and the healing ws fairly rapid from the inside out.

For wound that are difficult to heal there are Tissue Viability Specialists who are up to date on the latest treatments and what is allowed in your area, they should also be involved by now, they will arrange regular swabs and treatment with the right antibiotics if needed.

I hope your daughter gets the right teatment soon rather than be told what not to do with no solution offered.

Also check with the surgery as they often have volunteers that provide a free taxi service for patients with difficulties getting to and from the surgery

> Does she have another appointment with the surgeon or has she been discharged

she has another appt but not until the middle of February.

Could the district nurse not come to her if her travelling there was not helping to heal the wound?

> Is she eating well as diet is very important when it comes to healing

She says she is eating well and is taking the vitamins the nurses recommend. She doesn't have the money for a taxi as they are on a very low income.

The sponge sounds like a good idea. She has complained several times that she has been poked by the instruments the nurses use and also often she has to redress the wound as the dressings fall apart.

How does she get referred to a tissue viability specialist?

> Could the district nurse not come to her if her travelling there was not helping to heal the wound?

no they say she is mobile therefore she can't have a nurse visit except at weekends when the surgery is closed.

When things were not working then the nurses should have asked for their input, if asking the nurses for referral doesn't work then speak to her GP, this can't be allowed to continue with no progress being made.

Has your daughter considered phoning the consultant's secretary and asking for an earlier appointment?    It may be that once they know things aren't healing properly and she's concerned about it, they'll get things moving?

She's patently not mobile, if mobility is retarding healing. 

Is there any way to appeal to get the DN to visit. 

Lord when I was a child in the 70's the doctor visited if a child was ill with Measles or Tonsilitis.

I have no idea how ti works but in Bristol we have a Dial a Ride minibus service for the disabled, ill, elderly etc, and I have been told it takes people for doctors appointments etc. Perhaps there is a similar voluntary/council run service that will be able to help.

If she is on means tested benefits she may still be able to claim her fares (though that may have been done away with, worth finding out).

If she opts to be a hospital outpatient in some cases they will provide transport to hospital, like my friends late husband did for dialysis.

I take it it is a C-section? With the young baby.  I had the same issue after my section.  My wound kept re-infecting and opening again.  What my problem was when they closed the wound, a bit of skin folded over and because it was a warm place and summertime, infection set in easily.  I went major cleanliness!  I would wash the wound with Antibicterial soap everytime I went to the bathroom.  I would dry it with absorbant kitchen paper and then use talc to dry it right up.  Then I used cheapo sanitary towels to cover the wound and keep it dry.  I had to do this for about a month at least.  Then even after that, I had to wash and talc the area for months and months.  It has healed up fine now.

Hope she gets relief soon as it's a horrible thing.

I couldn't get my c section to heal , it burst open six times . The nurses just kept packing and dressing it but I got so fed up .
In the end I thought with my doggy head , what would I do if it were one of the dogs ? So I bathed it twice a day in epsom salts and it healed really quickly and I've had no bother with it. I honestly swear by the salts and it didn't sting as bad as I thought it would.

thanks, not a c-section, she did have one but that has healed fine. she had o have her gall bladder out just after baby was born. They messed around for so long with her treatment by the time they got round to removing it it was on the point of bursting so they couldn't use keyhole surgery. She has a huge  incision in her upper abdomen longer than a c-section. she has 2 sections of this which are open and the holes are 4cm deep and constantly weeping.

The nurses have told her not to touch the open areas so other than redress the wounds when the dressings fall off she hasn't touched the wound. I have texted her a list of everyones suggestions, (mainly so she has them on her and won't forget any of them) and she has promised to discuss all of them with the nurses today. Lets hope she can start to recover.

Is it the nurses who have told her she is completely mobile? Sometimes reception staff give out advice that whilst not exactly incorrect may be a bit inflexible.

A bit of big picture thinking would help here. It seems fairly obvious that the quicker she heals the less time she'll spend drawing on GP practice resources= money. Therefore it is in their interests to meet her halfway and perhaps agree to see her at times when you can pick her up etc.. or sort out taxis to and from the surgery- there may be volunteers who'll help.

I would also try find out a contact for the tissue viability nurses-even if she is unable to self refer they should be able to tell you who can and whether she appears appropriate for their intervention. Even if they do not see her directly they can advise the current nursing staff if necessary.

I feel so sorry for your daughter. My sister had major life saving surgery and ended up with infection in the wound which was still open 18 months after the surgery. She really does need to get on top of this as quickly as possible, even if it means stamping her feet at the Doctors.

An update. She managed to get an appointment with her GP today (a miracle in itself) He agrees that there is something wrong as so little healing has taken place and there is so much fluid being produced. He has referred her to a specialist at the hospital for further investigation. They are now using silver dressings to see if that helps.

Daughter asked about transport or a visiting nurse again but has been told she is not old enough to have transport provided (need to be an OAP) and they still wont organise nurses to visit as today they have decided that the walking is not a problem and is not delaying the healing. Strange that, as yesterday it was the cause of all her problems.