Anyone have a pt with non healing leg wounds?

  1. Has anyone had a patient who was a hairstylist for 30 years and now has non healing leg ulcers medial and lateral malleolus. Have tried dermagraft, aquacel AG, debridement, 4 layer compression, non stop antibiotics, the vac for only a few days because the pain was too great. Anyway, we can't get them to heal. Any suggestions? Not overweight, non smoker, has had many tests done and still no answers. Please help!!!
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  2. 13 Comments

  3. by   erroridiot
    Polymem is the only treatment that I have used with success for this type of wound. Of course, it will not work for noncompliant patients or if it is not used properly.
  4. by   suebird3
    Geez....had a good product that worked good....can't think of the name now. Will be going back tomorrow and will find out/let you know. All I can think of is it's a hydrocolloidal type dressing. It's been a few years, and my mind is mashed from working 11-7's!
    Last edit by suebird3 on Oct 9, '05
  5. by   suebird3
    Vigilon! That's it......Vigilon! You can cut it to fit wounds, but need a few 4 x 4's to soak up any "wet"; also can use ABD's But I think it did wonders.
  6. by   wenbonmac
    Quote from suebird3
    Vigilon! That's it......Vigilon! You can cut it to fit wounds, but need a few 4 x 4's to soak up any "wet"; also can use ABD's But I think it did wonders.
    Is that all you used was vigilon? What type of wounds were they?

    Thanks!
  7. by   suebird3
    It was a stasis ulcer on the foot top. Pretty nasty, too. Took a while, but had it nearly healed, too.
  8. by   night owl
    What about maggot therapy? If all else has failed, maybe it's worth a try. Do a google search. You'll find a lot of interesting info. I saw a TV show on the discovery channel awhile back that showed the maggots at work and boy, they really helped to heal the wounds and ulcers. To think of how much money is spent by facilities on these new fangled treatments when all you probably need are some sterile fly maggots. I have no idea on the cost of these little critters.
  9. by   suebird3
    Depends on Corporate, too. Sooooooo.....whatever Public Aid pays for, too.
  10. by   rands03
    There's a new tx Medicare approved only for home health agencies, it's called Anodyne therapy. You place pads of light on the wound using a clear barrier such as Saran Wrap, therapy lasts 30min 2-3 times a week and is administered by physical therapy, making MO825 yes. It really works, we were a little unsure at first but we purchased a machine anyway, and what a difference it has made in the quality of life for our patients. It is not only used for wounds but also Neuropathy, actually it's hard to say which it works best on! You can check it out on the web, they have their own site.
  11. by   NurseRachy
    How about medihoney? It's real honey from bees but a certain type with better healing properties. I have also used normal honey on myself, but that was just for a graze when i tripped. Worth a try..
  12. by   Cindy5
    There is a lot of stuff you have to look at when you are treating a non healing wound. First, is the origin of the wound venous or arterial? Can you feel her pedal pulses? Is there any edema? Does she keep her legs dependent much of the time?

    Does she have any pain with the ulcer?

    Are there any co-morbities such as diabetes or hypertension or peripheral vascular disease? This will affect the wound healing process and all this must be managed.

    How is her nutrition? Do you have access to lab values such as albumin or pre-albumin - this will give you an idea how good her nutritional status is.

    Have you recently cultured the wound? Sometimes people can have an infection, but not present with the classical symptoms of an infection.

    What does the wound bed look like? Is it red or pink? Is there slough or eschar in it? That will determine if the area needs to be debrided or not. Are the borders well defined or ill defined? That will help with diagnosis of type of ulcer.

    I am not a wound specialist, but I do work with a few of them. If you can answer atleast some of these questions, I'll ask them what they recommend. You really need to look at the entire picture of the patient - just looking at the wound itself won't give you all the information you need to determine best treatment.

    Even in spite of that, sometimes some things just work for one person and not for another. I've used a lot of trial and error in my practice.
  13. by   renerian
    I would get a referral to a wound care clinic to start. How is the wound since it has been along time since your original post?

    renerian
  14. by   ullnurse
    I agree with the idea of anodyne therapy. I have seen the results- they are unbelievable. Check it out on the web site.

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