[crista]

Does anyone out there have any experience with treating wounds infected with MRSA at home? I have a patient whom we just found out has MRSA in a diabetic ulcer (along with 6 other organisms). He was discharged from the hospitsal with this and our angency was not informed at time of intake! I am curious to know the extend of isolation precautions and the realities of dealing with this wound at home. I would imagine that by now there is MRSA contamination all over this guy's house! There doesn't seem to be any up-to-date info regarding this in the home-health setting. Any suggestions are appreciated.

[Cassandra Levescy]

Hi Crista
The main thing for you to do is to make sure that you and any one caring for him is gloving gloves. The aide if doing bathing or changing linens needs to wear a gown i.s. hosp. gown to protect theirselves. The pt. should be on an antibotic i.e. geocilin or what ever the organism showed sensitivity to. MRSA is hard to get rid of, have their be blood ,urine test done on this pt? That way you can know if it is only in the wound or in the other systems too. Watch for the pt. turning septic if in more than wound. I do know of a great wound product that if it can be healed this one will do it. Let me know how it goes.

[Ellen]

MRSA in the home is just like in the hospital. If you maintain universal precautions and teach the patient to follow strict handwashing regiment, no problem. yes, you should wear a gown if wound is large and you run the risk of splashing during irrigation. The new antibiotic Trovan has been shown to be effect for me several times with these types of infection. Remember to reculture, sometimes the organisms change and you might have something new to treat. The biggest problem I always have is with the patients keeping the old bandages in double bags.

[BenRNFla]

I've had good luck with Iodosorb Gel (Healthpoint Medical). It's a topical wound gel that's documented to be effective against MRSA. It's kinda like a time-released iodine, but is not toxic to healing cells. As someone else said, universal precautions would be essential. If this diabetic ulcer is on the plantar foot and the patient has neuropathy down there, be sure that the plan of care includes special foot wear to reduce pressure in the area. Also, remind the pt that w/o off-loading of the wound, it'll NEVER heal and that there's significant risk of amputation. Compliance is essential and hard to achieve when it doesn't hurt!

[crista]

Thanks everyone for your suggestions, I will be asking the doctor about those products you recommended. Keep in touch!