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We Need to Talk about Wound Care in Transgender Women Healing from a Vaginoplasty.
I'm surprised that he works at a facility that routinely sees vaginoplasties, and yet there isn't a better post-op dressing plan than "lol reinforce it, whatever." Where's the facility's wound/ostomy/continence nurse? For that matter, wouldn't bedside nurses have asked the surgeons at various points about what to do if the dressing is stooled on?
I wonder if there have been dozens of unrecorded verbal orders about redoing the rolled gauze but leaving the vag packing. Something that unglamorous and hands-on wouldn't make it to the committee that updates the surgical order sets, but a nurse on a surgical unit gets to know the preferences of the usual surgeons.
(Dr. Smith is fine with you changing out the lumbar dressing if it's saturated immediately post-op; Dr. Jones only ever wants it reinforced; Dr. Nguyen is OK if you psychically receive orders for bowel care and don't actually call after nine.)
Back to the article: it's so
unpractical. Using the "we need to talk about" construction is tumblr-tier, and then his three "solutions" are to hire trans nurses, expand the m/f marker in the EMR, and "share stories." There's only one hard statistic in the piece, and it's the "up to 30%" post-op infection rate, which is the same as "30% or less."
How does that compare to other urogenital surgeries' infection rate? Who knows, and who bothers to check? Not this bedside-noob-direct-entry-into-MSN, heading to his DNP per the bio.
That seventh paragraph is really the load-bearing paragraph: along with the only statistic, it mentions that there are no vaginoplasty wound care recommendations in the literature so far. Wouldn't that mean that the thing to do is to
start looking at post-op results, collating similar wound care protocols and recording their outcomes as useful data for quality assessment? Reaching out to a CWON for input?
No, no. This dude's focus is
awareness. It'll make all the difference if a MtF RN is the one reinforcing the rolled gauze over stool, and that's it.