Nikki Lee:  For truly deed wounds or wounds with obvious infection or
copious drainage, I absolutely agree with you in terms of healing from the
inside out with packing in place.  The problem here is that the wound is not
excessively deep or large and IMNSHO it could be ready to close.  Current
thinking in wounds of this type is to get it closed as soon as possible (and
I've even seen the use of a vacuum instrument employed to suck long tunnels
closed and hold them closed for 48 hours until cell growth occurs).  All of
this, of course, requires a trained clinician to evaluate it frequently--if
it starts to close and inflammation and redness are apparent, then packing
needs to be resumed.

For those who wonder how a non-hospital based, non-RN or MD knows this...my
recent absence from LN was due to a very poor surgical outcome resulting in
a 20 cm in diameter hole (7 cm deep) with 2 tunnels going 17 and 19 cm out
in either direction.  The wound had 4 different bacterial infections, what
seemed like tons of necrotic tissue and required almost 6 months of a
variety of packing techniques, topicals, TENS (to stimulate blood vessel and
nerve growth, and vaccuum.  The certified wound care specialist who treated
me was a God-send in providing many clinical documents on the "latest,
greatest" research and techniques.

Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC    [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.

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