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- by followyourbliss Apr 29, '12Hi Everyone,
I have a challenging sacral/coccyx pressure ulcer stage 2 wound with incontinence present and the dressings we have tried are all slipping off, being peeled away due to moisture, heat, and friction.
The gentlemen is very emaciated, in acute pain, and elderly.
Ideas and thoughts please!
For the record we have only Mepilex products on hand...
Thank-you in advance.
Follow Your Bliss
- May 5, '12 by mommy.19Firstly, is the patient wearing a brief? If so, those need to be discontinued if possible. If dry-flo pads can be obtained, these are wonderful for wicking away moisture/heat. If it is only a stage 2, offloading and a good barrier cream are indicated (per our protocol). I would focus more about using a barrier to reduce friction/shear on the skin and also to protect it from the excoriation of urine/stool. A mepilex dressing sounds like it is ideal since they are thick, rather padded foam dressings, and we often use them for comfort even when the wound type/drainage does not indicate need for an absorbent foam. Offloading and management of incontinence should be part of the plan of care for this patient, which will be more important than anything you actually put on the wound.
- May 6, '12 by NurselaceyHi I am interested in becoming a wound care nurse. How would I go about that? I am currently a Psych nurse and I am almost finished with my BSN.Thanks!
- May 9, '12 by CmenurseLike Mommy19, I have found that what you keep OFF the wound-heat from briefs, pressure from sitting on it, poop and pee-are as important as what you put ON it.
Is your gentleman bedbound? Keeping him turned is major. Decreases pain and pressure. try not to let him sit on it more than 15 minutes without changing position slightly (I know, no one has time for it but that is what works)
And of course, nutrition. Is he eating or drinking enough protein to grow new skin?
Mepilex, medipore, any good dressing that doesn't remove the skin when you take it off will keep the wound clean and catch the drainage. but it is the offloading and nutrition that really starts the healing.
Hope that helps you some. Pressure sores on elderly people are a real challenge.
- May 14, '12 by RuthfarmerSome skin prep applied to wound edges will protect the skin and might help the mepilex stay in place. As mentioned by others, offloading and nutrition are crucial to healing, as is tight glycemic control.
- Jul 17, '12 by CAB1437Nurselacey,
Good for you for entering in to a wonderfully rewarding field. There are many ways to enter in the the role of Wound Care Nurse/WOCN.
Here's my story: I became a member of a unit based skin care team in 2008 (Gradunated with ADSN in 2006), Applied and got an opening in the wound care department of the same hopsital the same year, trained by AMAZING wound care team (Both WOCN and PT's) for 2 yrs, went to the WCC course and compelted it in 2010, Completed by BSN in Dec 2011 (moved away and worked in trauma as there was no wound care openings near by new home), currently at Emory for WOCN && a Wound care nurse for a mid-sized hospital since April.
Your best bet, since your almost done with your BSN, is to attend a WOCN course and soak up all the knowledge you can. I was blessed with experience before certification, but so many do it by going to school first. I can say, you'll never regret a day of it!!