Duoderm, Tegaderm, Wet Gauze

Nurses General Nursing

Published

Which or what else do you prefer for a sacral stage II in a very immobile, bed-bound patient? What do you suggest? Any treatments with which you have successful outcomes? I would really like this to heal.

Thanks.

corky1272RN

117 Posts

Specializes in Med Surg, Home Health, Dialysis, Tele.

The choice in treatment also depends on things like: what does the wnd bed look like, how much drainage is there? Do you need a dressing that debrides? that absorbs excess drainage? something to keep the bed moist because there is no drainage? As a former home health nurse, I have seen almost every type of dressing. Some of the decision is also a "try, see, and wait" game. One dressing may work on person A and not person B, and no two wounds are the same. :paw:

Simple stage II secondary to immobility and incontinence. Guy's tube-fed. HOB always 45 dg angle. Makes it hard to do much repositioning.

No infection, drainage, simple open area. New wound. Maceration on the edges 2o moisture.

corky1272RN

117 Posts

Specializes in Med Surg, Home Health, Dialysis, Tele.

Oh sorry, for some reason I misread and thought the wound was a stage III. Anyway, duoderm is really good choice because it is cushiony, has hydrocolloid (protein) to aid in wound healing, and easier to remove. But any sacral dressing for an immobile/incontinent pt is hard because of it getting messy and everything.

Specializes in Critical Care.

I have also wondering the same thing...I've seen tegaderms used on tear tears. And where I am now they use duoderms on alot of things. I think they work good but some people don't know that you are supposed to leave those things on for a couple days. Not the type of dsg that you switch frequently...I like them for the coccyx and anything on the back..they are tough and last a while. I HATE bedsores, but they happen...Has anyone use calmospetime ? I swear by that..esp people with diarrhea, and their butts start to get red...it really helps protect the skin.

I love calmo. LOVE it. I have also heard people say that Skin-prep protects those sensitive areas.

Okay, I'll stick with the Duoderm. That's what we've been using. But I'm changing it to a bigger one and I think we'll change it 2x week instead of once. I want to watch this. The guy is really weak and I think he's on his way out but I want him to go in one piece.

Thanks for the help, all.

pennyaline

348 Posts

Oh sorry, for some reason I misread and thought the wound was a stage III. Anyway, duoderm is really good choice because it is cushiony, has hydrocolloid (protein) to aid in wound healing, and easier to remove. But any sacral dressing for an immobile/incontinent pt is hard because of it getting messy and everything.

Duoderm (or other hydrocolloid dressing) would be my choice, too. Wet gauze is for debridement (assuming you're talking about a wet to dry dressing) and a Tegaderm is only good for covering I.V. insertion sites IMHO. The Duoderm hydrocolloid will absorb the skin's own moisture and create a moist surface against the wound bed, an important point for granulation and wound healing, and it's adhesive backing will help to hold it in place while its outer membrane will repel contaminants longer and better than gauze.

pennyaline

348 Posts

I love calmo. LOVE it. I have also heard people say that Skin-prep protects those sensitive areas.

Okay, I'll stick with the Duoderm. That's what we've been using. But I'm changing it to a bigger one and I think we'll change it 2x week instead of once. I want to watch this. The guy is really weak and I think he's on his way out but I want him to go in one piece.

Thanks for the help, all.

A Duoderm dressing should be changed q48-72 hours, depending on how icky it's getting ;)

A Duoderm dressing should be changed q48-72 hours, depending on how icky it's getting ;)

Huh. We've been doing once a week. I'll change all of those.

Thanks!

Duoderm (or other hydrocolloid dressing) would be my choice, too. Wet gauze is for debridement (assuming you're talking about a wet to dry dressing) and a Tegaderm is only good for covering I.V. insertion sites IMHO. The Duoderm hydrocolloid will absorb the skin's own moisture and create a moist surface against the wound bed, an important point for granulation and wound healing, and it's adhesive backing will help to hold it in place while its outer membrane will repel contaminants longer and better than gauze.

I won't use wet-to-dry anymore. Period. I've seen too much insult to a nicely-granulating wound bed to like them.

LucasRN

172 Posts

Specializes in med/surg- sub-acute, LTC,ICU,.

Hi, applying skin prep after wound has been cleansed and dried provides a protective covering "almost like a second skin to the wound helping to prevent maceration from incontinence", also there is a dressing called allevyn, it has a very fluffy cushion which helps to offload the pressure in those tricky areas, if your facility does not carry it , ask your manager to give the company a call they are always glad to send free samples, this way you can try it out. Good Luck.

mauxtav8r

365 Posts

duoderm is really good choice because it is cushiony, has hydrocolloid (protein) to aid in wound healing, and easier to remove. but any sacral dressing for an immobile/incontinent pt is hard because of it getting messy and everything.

i beg to differ. i have seen duoderm do more harm than good on dressing change day. do not attempt dressing changes prior to the recommendation.

if you are willing to leave the wound open, using an ointment, i'd like to see you try xenaderm (peruvian balsam). it stimulates the circulation to the wound area, provides a protective barrier (similar to calmoseptine, but not as thick and messy).

with a stage ii with prospects for healing, the duoderm is, imho, a poor choice. in my geographical area, it is considered "giving up" on a wound due to the lack of progress usually made with it. in its favor, it is very durable and tolerates turns and cleanups well. but, it does have a tendency to roll on the edges which is also damaging to tender skin.

i think duoderm is best left to burns, for which it was developed.

nice discussion, all. sue, always enjoy your enthusiastic comments.

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