My husband who is 69 and weighs 190 lbs. recently had a below the knee amputation.  Within one month the lower limb was infected and he is now in the hospital after they did an above the knee amputation.  I have a couple of questions.  First, the surgery was done this past Monday late afternoon and when I left today which is three days later he still did not have any bandages or wrappings covering the incision/staples and a small open area for drainage of blood.  After the first amputation the doctor had specific wound care orders which was dry dressing to be checked every day and changed every day.  This time...the doctor signed off the case within 24 hours and left no wound care instructions.  I have been asking the nursing staff, the hospitalists, etc. why the limb is not covered and today my answer from two doctors and a wound care nurse is that it is better for it to be free from dressings and just be open air.  I told them I didnt agree and that did not go over well and was told when I receive a medical degree or nursing degree then I could voice my opinion.  I am extremely concerned about infection as his first amputation was infected and is still on IV antiobiotics for treatment of the infection.  He has had periperal vascular disease for 15 years and the amputated limb has an old graft that took three angioplastys to open the blockage for the first amputation.  My husband has had a Urinary Tract infection since the first amputation up to today.  They had to drain his bladder twice because the readings were showing urine retention in the 700 range.  I mention this because one of the doctors who is refusing to bandage his upper limb says if the urine should get in his open new wound it could not cause an infection?  I also questioned dirty sheets being placed on top of the wound, my husband touching the wound with dirty hands and just plain old germs that are everywhere in the hospital.  Isnt a Urinary Tract Infection mean there is bacteria in the urine.  Because he has had this UT Infection he has been using a urinal and it spills all the time.  The would and open incision are very close to his penis and the urinal is touching his limb all the time.  Should I be worried about infection without this wound/staples being bandaged and the fact the urine is getting on the open wound area.  The lower limb was so badly infected that it had turned black and their was no choice but to amputate higher.  Shouldnt the doctors/nurses be more concerned about infection setting in this new amputation would or am I just worrying needlessly?  Please reply as soon as possible as this is really stressing me by worrying about him and his care he is receiving.  Thank you so much in advance for any help or answers.  Sincerely, a very concerned wife/caregiver.
Thanks for consulting. I have carefully worked through your case, and I can realize your health worries. Being your physician, I assure you not to worry as I will take care all of your medical concerns. Your husband must have got the urinary tract infection when he was put tube for urine first time. Following an amputation for an elderly person the chance of infection are high so that's why he was given an IV antibiotic. That too if he is having diabetes the chance of infection are even more high. Kindly take care that by no way his urine comes in contact with the amputation wound. The mater of content is not that your husband having urinary tract infection. The normal urine itself is full of germs. Hospital is the worst place to manage the amputated wound like this. Hospitals are full of bad and strong germs. MRSA is a nightmare and is common in hospitals. My advice will be you personally learn from the health professionals and get your self trained in cleaning the wound, and you do it every day from your home. Also it is better to keep the wound open rather than keeping it closed as the temperature inside a closed wound becomes favorable for germ to grow. In open wound the oxygen in air and cooler temperature becomes unfavorable for the germs to grow. But extra care must be taken to keep the bed and bedsheets clean. Keep a check on the sugar levels and keep it controlled in normal range. Hope it helps. If you need further, detailed and quick assistance related to any health issues in the future, feel free to ask me a question directly from my profile. Have a wonderful time ahead. Best Regards!