Hi, I have been a nurse for two years now and I work on med-surg. We don't have a ton of patients with pressure ulcers, and the ones we do see we usually put a tegaderm on and they get discharged and we don't ever see the results of our treatment. Recently though I have had a couple of patients for a longer than normal stay (over a week) that have had stage III ulcers on the sacral area, and it was not until now that I have realized the debate/controversy over wound care/treatment. It does not help that there is no policy or wound care specialist at my hospital. It seems that every nurse has a different opinion and is very sure of themself. I have done research on this, and even went to a wound-care conference on this, and I still don't feel like I know what to put on these stage III sacral ulcers.
For one thing, we don't have any cool treatments, all we have are thin and thick hydrocolloids and opsites. Many nurses I work with think open to air is the best policy, besides obviously turn Q2 and nutrition, but I lean towards the moist wound healing offered by opsite and the tegaderm. The only problem is the wrinkles that form when these are placed on the sacral area. I have tried every trick to get them on smooth and perfect but they always end up wrinkled.
Also, how do you keep the intact skin around the wound from being macerated, and how do you know when the exudate that is supposed to be healthy for the wound bed is not so healthy any more?
Any insight or tips at all wound be helpful. I even asked the doctor this morning and she didn't know- she said she is used to having a wound care nurse to ask...
so it is in my hands at this point.
Thanks a lot!