need help with stasis ulcer!!

  1. Hello everyone. Help needed here. I have a patient with a 1.8x0.8x0.5 venous stasis ulcer. Originally places bacitracin with dressing and compression to insure no infection was present since md did not place patient on antibiotics. Then I placed a Coban 2 layer compression system. Had to stop that, patient didn't like it.. since it was bulky. After first treatment there was a lot of granulation present. So I was set that this wound would be a breeze. Well wound has haulted. Compressions have to helped. I had started to use purocal dressing in hope to stimulate healling but no luck. Going to put multidex gel next visit in hope maybe something can start happening. Any advice??
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  2. 11 Comments

  3. by   CK11669
    Compression is key. Look up edemawear by compression-dynamics.com! Great results and compliance from pt.
  4. by   paradiseboundRN
    Status ulcers are nearly impossible to heal. Compression is the key. Do you have a wound care clinic you can refer the pt to?
  5. by   erika.RN
    I have good luck applying aquacel AG cut to size on stasis ulcers when they are very wet. Calmoseptine to peri-wound if they are really draining. If they get necrotic santyl helps debride. I wouldn't say stasis ulcers are impossible, just time consuming & the dressings should be changed daily.
  6. by   somenurse
    Quote from CK11669
    Compression is key. Look up edemawear by compression-dynamics.com! Great results and compliance from pt.

    How does compression help? by preventing accumulation of edema in the area?

    Would you also recommend this if the patient had no edema at all?


    Sorry, this is new idea to me! I did look over the edemawear by compression-dynamics. The patient would wear a torso type of girdle? Is that right?
  7. by   KittyLovinRN
    I know this was a few months ago but I've had great luck with calcium alginate dressings with compression wraps!
  8. by   traumaRUs
    What about revascularizing the extremity?
  9. by   tktjRN
    Try iodoflex and cover with a foam adhesive pad. I use this treatment regularly with 100% success
  10. by   jmn126
    Idoflex? Not familiar with that, can you explain...do u also use dompression? Tanks
  11. by   Detroitrn59
    I have a patient that gets daily dressing changes. Lymph edema, stasis ulcers. The wound clinic has be doing xerform, then 1:5 vinegar solution (acetic acid?) kerlix fanned on wounds, then ABD pads followed by kerlix, and compression wraps. They are doing nicely with this combo.
  12. by   tktjRN
    Iodoflex is a cadexomer iodine pad, antibacterial, forms a gel over wound, great for debriding wounds, absorbs 6 times it's weight. Its my dressing of choice for venous ulcers. I use it under 3 and 4 layer compression. I have 2 patients now who cannot tolerate compression. I use the iodoflex and cover with a foam adhesive. The iodine is released slowly so you're only changing the dressing 2- 3 times weekly. I usually schedule it every m,w,f. I use iodoflex or iodosorb on all my venous ulcers.If a patient is sensitive to iodine, my second choice for venous ulcers would be aquacel ag, cover with duoderm, then compression wrap. Iodosorb is also wonderful on heel ulcers.
  13. by   tktjRN
    If the patient cannot tolerate the wraps, use tubigrips

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