Your doctor has recommended that you undergo surgery to repair your ruptured Achilles tendon.
But what does that actually mean?
Your Achilles tendon is the connection between the heel and the most powerful muscle group
in the body.
It is the strongest, largest and thickest tendon in the body.
It begins in the mid-leg and descends to the heel.
Unfortunately, the Achilles tendon is extremely susceptible to acute and chronic injury because
of the demands it withstands.
When it ruptures, patients feel a "pop" and may feel that they've been struck from behind.
This is often followed by weakness and pain.
After allowing a few minutes for the anesthetic to take effect an incision will be made in
the long axis of the ankle over the injured tendon.
The incision is carried down through the skin, exposing the underlying tendon sheath.
The sheath is then opened to reveal the tendon itself and the contained damaged Achilles
tendon.
The damaged portion of the tendon is then cut away, taking as little tissue as possible,
but cutting back to strong, viable tendon fibers.
The surgeon weaves sutures through the tendon fibers in a pattern designed to hold with
good strength.
Then the two tendon ends are pulled into contact and tied securely.
Finally, the incisions are closed with sutures.
After sterile dressings are applied, a well-padded splint will be fitted.
Handwashing
Germs are present always on your hands and they can be transferred to:
* other parts of your own body, * to the family member for whom you are caring
* your patient * and to any clean object that you touch.
By washing your hands correctly:
* you remove germs from your hands.
* Handwashing is the single most important way you can prevent infection from occurring
and * prevent the spread of infection.
You must carefully wash and dry your hands:
* Before and after each time you care for your family member or your patient.
* Before and after you handle your patient's and your own food and drink.
* Before and after you manipulate any contact lenses.
* Before you apply and after you remove gloves * After you use the toilet.
* After you cough, sneeze or blow your nose.
* After contact with anything that could be soiled or have germs on it.
* After you pick up any object from the floor *
Handwashing takes a minimum of 10-15 seconds, * longer if your hands are soiled.
* The longer you wash, the more germs are removed.
* The friction generated by rubbing your hands together removes the germs from your skin
and * running water can then wash them away
* Every time you wash your hands, take your time and don't rush.
* Do the handwashing carefully and thoroughly.
Use liquid soap from a dispenser.
Bar soap holds germs on its surface.
Make sure you have paper towels and a waste receptacle nearby.
Remove all jewelry from your hand except a wedding band and push your watch and sleeves
up, away from your hands.
Turn on warm water.
Point your fingers down to prevent water running onto your arms and wet your hands.
Apply soap from the dispenser.
Point your fingers down and rub your hands vigorously together in a circular motion.
Star counting seconds at this point.
Intertwine your fingers to clean all surfaces of the fingers.
Rub your fingernails against the palm of the other hand to get soap under the tips of the
nails.
If your nails are soiled, clean under them with an orange stick or brush.
Keep your hands down and continue to rub them together in a circular motion until the end
of your count for 15 seconds.
Keep your hands down and rinse them from the wrist to fingertips.
Pick up a clean paper towel and turn off the water, still keeping your hands pointing down.
Discard the paper towel into a waste receptacle Pick up another clean paper towel and carefully
and completely dry your hands.
Discard the paper towel into a waste receptacle.
The key points to remember are:
* that friction is critical for removing germs * and the friction should be applied for at
least 15 seconds.
* Always keep your fingers pointed down * and turn off the water with a paper towel.
Wound Care
The equipment you will need to assemble includes:
* 2 pairs of clean disposable gloves * cleansing solution;
* small gauze pads for cleaning * large gauze pads for dressing the wound
* adhesive tape * a large sealable plastic bag.
Carefully, wash and dry your hands.
Put on your gloves.
The first step is to remove the old dressing Loosen the edges of the tapes and peel the
tapes off the skin by pulling them towards the wound,
keeping the skin taut with the other hand Lift the tapes and the dressing off together.
Note any odor and the color of any drainage on the dressing.
Discard the dressing and tapes into the plastic bag
If the dressing sticks to the wound, pour a little cleansing solution onto the dressing
and let it sit for a minute.
Gently pull the dressing off, keeping the skin taut above the wound
Look carefully at the wound.
Any of the following should be reported immediately to your doctor or nurse:
* redness of the wound or surrounding skin * drainage from the wound, particularly if
it's yellow and smells * any bleeding
* swelling of the skin around the wound * separation of the edges of a sutured wound
* or maceration, a waterlogged appearance of the edges of the wound.
Pour some cleansing solution onto a small gauze pad, squeeze out the surplus solution
and, with one stroke, clean the wound from top to bottom.
Discard the gauze pad into the plastic bag.
Using a fresh gauze pad with cleansing solution for each stroke, work away from the wound
to clean the skin for about three inches from the wound on either side.
Stroke from top to bottom and discard each gauze pad into the plastic bag.
Remove your gloves and discard them into the plastic bag.
Wash and dry your hands.
Open the package with the large gauze dressing.
Put on clean gloves.
Pick up the gauze dressing, holding it only at two diagonally opposite corners
Center the gauze pad over the wound and place it on the wound.
Tape the dressing securely in place.
Remove your gloves and discard them into the plastic bag.
Seal the bag securely and discard it into the trash
Wash and dry your hands.
If your skin is sensitive to the adhesive on the tape,
* hypoallergenic tape can be bought at your surgical supply store
* or bandages or binders can be used to hold the dressing in place.
Consult with your doctor or nurse.