What do you guys put on your trauma patients with nasty abrasions from skidding along the road. We have different people using different things at work - would be interested to hear what others do. For the nasty ones I'm a fan of xeroform. Any suggestions??
Jul 1, '06
It depends on the doctor. Occasionally I have seen a phisoderm wash, rinse with saline then xerofoam dressing. Occasionally i have seen just saline cleanse and TAO with 4x4 dressing. Different docs have different ways of cleaning road rashes.
Jul 10, '06
If it is yucky and oozy and not looking so hot (maybe infection setting in...), we have used silvadene cream covered in gauze. Works AWESOME. Only for goopy icky ones, but applying it twice a day, wrapping it in some dry gauze to let it do its thing.....cleans those things up and helps heal them in only a couple days.
Otherwise.....some aquafor under dry agauze if the drainage is not so much, xeroform if it is goopy but clean/not infected. If the area is smaller and has minimal drainage, duoderm can also work really well. I love that stuff! I had a burn on my hand that was oozy, and I applied duoderm, kept it on x3 days, showered, etc with it, then took it off after 3 days and had a clean, dry healed wound that was not macerated like it would be with a bandaid sort of dressing. Wonderful stuff!!
Our docs have no clue about any dressing other than wet to dry, so we end up just telling them what we want to do and getting the order to do it.
Jul 10, '06
We use Mepitel dressings.http://www.directmedicalinc.com/wound/mepitel.html
It lays directly on the road rash, and can remain for up to 7 days. You cover with dry guaze. Daily you remove the dry gauze (more frequently if there's a large amount of drainage). Cleanse with normal saline, blot dry, but leave the Mepitel on.
It seems to work very well.
I'm also a fan of leaving it open to air to dry if it's not too deep or draining.
Jul 26, '06
One of our plastics guys had the patient stand-if able- in the shower (with the nurse's help-think bad hair day for the rest of the shift). It seemed to work then Bactroban lavishly. That silicone stuff looks great. Haven't come across that.
Jul 27, '06
To initially clean the road rash, lidocaine jelly 4% covered with a piece of saran wrap for about ten minutes and you can then really clean it well. You usually need to get the stret pieces out of the wound before you can get any chance of proper healing.
Used this in the ER setting for years and years.
Jul 27, '06
Thank you all for your replies. Got some great new ideas.