Chopped off Fingers and The Worst Dressing Change

The phone rang, it was early Tuesday morning.  “Ruth, would you be willing to see my yard worker?  He was in a motor cycle accident yesterday and went to the hospital.  He received stiches and they told him not to come back until Thursday.  But his dressing is soaked through with blood.  Could you please see him?”  Wounds?  Dressing Changes?  Ha, my favorite type of nursing….I was game! 

I was not prepared for what this would entail.  The dressing was indeed soaked with blood that had then dried in Papuan humidity.  This dressing was wrapped around a stump of a leg (from birth).  It took a complete liter of IV solution to wet down the dressing so that it would come undone.  The smell was indescribable and lingered in my nostrils for hours beyond the job.  If all that was not enough, there were ants crawling on this dressing.  The wound revealed grey dead skin that was sutured.  I knew this wound would take daily follow up.

There was also 5 more small wounds on knee, hand and face.  Each presenting with yellow slough, instead of a nice pink clean wound bed.  And so began my daily visits with this humble man who usually hobbles around with a crude wooden stick and lives in a very simple home.  11 people live in the home.  From a grandmother figure to quite a few young men to several young children.  Non of them are related they say, just friends.  The older lady caught my attention as she sat making a traditional Papuan bag, that people carry everything from school books to babies in.  What intrigued me were her hands.  Fingers had been chopped off.  We had a great discussion on this form of Papuan culture.  It is most common amongst the Pagan people and they say rarely happens now, but still does in some places here.  When a family member dies then a relative’s finger is chopped off to appease the spirits.  They laughed as I shuddered. 

 

For the first 2 days I tried antibiotic ointment and an opened capsule of antibiotic pored on the wounds to see if that would promote healing.  It helped, but was not fast enough (to my liking).  Wound care is a grand experiment (and a science) seeing what works with what patient.  Unfortunately, I was all out of my favorite wound dressing (Polymem from America) so I couldn’t fall back on that.  Yesterday I tried mixing in Hydrogel and today I could tell that the slough was thinning.  On one of the wounds I tried some Papaya that was not yet ripe.  I am told, that this is great for healing wounds.  Again, I wanted to experiment and see if this is true.  The papaya did not work fast enough to my liking either.  Perhaps if it were a deeper tropical ulcer and I had made it into a more mush like consistency I would have been happier with the results.  In the end, I stuck with the Hydrogel.

It is a real privilege to work with a Papuan man.  Unfortunately due to government regulations we are not allowed to treat Indonesians, but can help them in their homes and “consult” only.  It is rewarding every day to put on fresh new white bandages and know that this man is getting the care he deserves.  I have never experienced a dressing change that was so desperately in need of help.  It was the worst dressing change.  I love being part of the hands of Christ.  There is no greater privilege.  And thankfully I have all the fingers on my hands to serve.

 

(I wrote this on Saturday.  Finally getting around to posting it on Monday.  Tonight his wounds look so much better.  I removed the stiches in his face.  The yellow slough is all gone on his hand and knee.  And today was the first day that his stump wound did not look grey, but actually had a pinkish hue.  Whoo hoo, I think this man is going to pull through!)