To reduce the increased risk of surgical site infection, please:
1) Dressings on legs should be Opsite, not honeycombe dressing Opsite Visible.
2) Consider leaving bellovac longer than Day 1-2, if it is still draining (the action of drain on wound site is different to the action of compression bandage).
3) Consider leaving/re-applying compression bandage longer than Day 1-2, particularly if patient is oedematous/marked weight gain post op.
4) Compression bandage should be applied uniformly, from high up on thigh to toes for long incisions. If you do not know how to apply a compression bandage appropriately, seek support from the Practice Educator in your area.
5) Along the incision, consider folding a dressing to build compression before applying secondary dressing.
6) Patients should be encouraged to mobilised and have leg elevated when resting. Inform team of daily weight.
7) Patients should always wear underwear (provide disposable pants as necessary).
8) Dressing the leg wound should only be after patient shower and in a clean bed space.
9) Dressing pack and aseptic technique need to be performed separate to sternal wound management.
10) Always use APPEEL wipes on underneath of dressing film to loosen the dressing before removing it to reduce the risk of skin tears.
11) Introduce an absorbent dressing early, to reduce the number of times the dressing is changed.
For further details on lower limb management and information on skin tears affecting donor incisions, please see Rochon, Morais and Mahiout 2014 Blistering and skin stripping affecting CABG patients