25 July 2018
Ms Cathy Ina
06 Buchanan Street
Dear Ms Ina,
Re: Mrs AnnaDijana,
I am writing to refer Mrs Anna Dijana who underwent fasciotomy and external fixation secondary to fracture of proximal and lateral plateau in right tibia, requires follow- up assessment and management from your service. She is being discharged today.
Mrs Dijana was admitted to New Victoria Hospital on 15 July 2018 with the complainants of right knee pain and inability to bear weight owing to a fall.During hospitalization, two incisions were made for compartment syndrome .Post operatively, a vac therapy has been commenced and assessed for drainage as well as signs of infection. She was treated with pain medications. Currently, she has made good progress without any complications.
Mrs Dijana is married and has two children. She works as a teacher and drinks socially.In terms of her medical history, she has seizures
For which she is on carbamazepine.
In view of the above, it would be appreciated if you could take over the case of Mrs Dijana and educate her regarding monitoring of wound site.It would be essential to notify a nurse urgently if any signs and symptoms of infection is noticed. Kindly inform her how to get rid of infection and to keep the wound area sterile by avoiding contact of clothings from the wound. Her visitors are also need to educate regarding this matter. A detailed instructions about the wound drainage also is highly recommended.
If you require further informations regarding Mrs Dijana, please do not hesitate to contact me .