Patient Details

Candesartan 16mg PO mane

Hydrochlorothiazide 12.5mg PO mane

Atorvastatin 40mg nocte

Esomeprazole 40mg mane

Aspirin 100mg daily

Clexane 40mg S/C nocte

Paracetamol 1g PO QID

Endone 5-10mg PO Q4h PRN

Ondansetron 4-8mg SL Q6h PRN

Mr Ryan proceeded to a left femoral popliteal bypass to improve his claudication. The operation was successful with no intra-operative or post-operative complications. Mr Ryan had been up and mobilising, only requiring small amounts of analgesia, tolerating diet well and looking forward to being discharged home soon.

This is now day four post the operation and you have been asked to see the patient due to excessive strike through on the dressing with some increased pain. On taking the dressing down, there was a central wound dehiscence with some purulent looking material. The patient’s observations were stable and he has been afebrile. He has had no systemic signs of infection.

Cholecystectomy – From cholelithiasis. 

Hypertension

Dyslipidaemia

GORD

Peripheral vascular disease

ACE inhibitors – Cough. 

His mother is 87 and has ischaemic heart disease She had one previous acute myocardial infarction eight years ago but made a good recovery. His father died of bowel cancer 15 years ago at the age of 73. 

Mr Ryan is a chef who lives in Singleton with his de facto partner of 12 years. He has 3 adult children from a previous marriage who all live away. On average, he drinks two standard beers per night and has a 50 pack year smoking history, starting at age 15. He remains a current pack-a-day smoker.