favorite wound products - page 2

Say, hypothetically you have all the money in the world at your disposal.:chuckle Patient is 90 yr old NIDDM patient with dementia and constant oozing of stool. Her status is palliative, and... Read More

  1. Visit  sunnygirl272} profile page
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    also called fecal containment device...similar to colostomy bag, but around anus instead of stoma...there are devices special for this, but for the life of me i cannot come up with a lijnk for you....
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  3. Visit  hoolahan} profile page
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    OK, my two cents...How about a hydrogel, like carrington, covered by a large duoderm. The duoderm keeps it water proof, protects from stool, and keeps moisture in the woundbed. It can also stay on for about 3 days, or removed prn for stool problems.

    Agree with the air matress for the bed, or maybe a clinitron is probably best for this pt.

    Also nutrition must be addressed. If nutrition is not adequate the wound will never heal. Are her sugars under control? I think add ing the vitamins as suggested by sleepyeyes is an excellent idea!!!

    You have to attack decubs from the big three nutrition, pressure, and hygeine, at least that's what I see working the best. When all three factors are being aggressively addressed and managed, the wound will begin to heal.
  4. Visit  sunnygirl272} profile page
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    if i remember right,
    medicare doesn't feel these would be necessary together...
    Last edit by sunnygirl272 on Jul 22, '02
  5. Visit  adrienurse} profile page
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    Sugars are under control. Despite everything, it's amazing what this lady does have going for her. She has been on a multivite for some time.

    Duoderms are good for stages I-III, but not really advisable for stage IV. Can't remember exactly why but they can increase levels of bacteria at the wound site (I think).
  6. Visit  hoolahan} profile page
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    Well, then the only thing I have ever seen work for a stage 4 decub is clinitron bed. We had one pt w such a huge decub and he had such diarrhea, and we were not allowed to use chux, b/c the wound is supposed to make contact w the bed. It was gross, the bed was all stained from the poop, and the pt had to lay in the stained area, which to me seemed so gross and unsanitary, but it did heal the decub. I believe Medicare does cover a clinitron for a stage 4 decub.

    I know duoderm isn't indicated for stage 4, just thought maybe it would keep the wound clean from the stool.

    Has the pt been seen by a plastic surgeon?

    Let us know how it turns out!! Good luck to you, this pt is lucky to have you as her nurse, your concern for her speaks volumes about the kind of nurse you are. :kiss
  7. Visit  Love-A-Nurse} profile page
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    originally posted by shygirl
    panafil is an enzymatic debridement product. go to: http://www.medicaledu.com/enzymati.htm
    panafil would have been my suggestion but since the wound does not need to be debrided, it defeats the purpose and panafil, for what i have seen, heals near the surface and keeps the wound from healing completly. cleansing with ns and applying santyl bid should do the "trick".
    Last edit by Love-A-Nurse on Jul 23, '02
  8. Visit  Love-A-Nurse} profile page
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    originally posted by adrienurse
    sugars are under control. despite everything, it's amazing what this lady does have going for her. she has been on a multivite for some time.

    duoderms are good for stages i-iii, but not really advisable for stage iv. can't remember exactly why but they can increase levels of bacteria at the wound site (i think).
    duoderms keeps the wound moist, or it can depending on the wound, and some wounds needs to be clean more than a couple times a week. duorderms products are designed to stay in play for a specific amount of time and usually without other products to help aid in its healing effect. therefore, a wound such has you have describe needs more attention than the duorderm protcol.
  9. Visit  Love-A-Nurse} profile page
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    another thought, have you tried a wet to dry for a couple of weeks then moving to santyl? as i am sure you are aware, it takes at least a week or so to determine some out- come from what ever product is being use to rule it out or not.
  10. Visit  Sleepyeyes} profile page
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    Originally posted by hoolahan
    Well, then the only thing I have ever seen work for a stage 4 decub is clinitron bed. We had one pt w such a huge decub and he had such diarrhea, and we were not allowed to use chux, b/c the wound is supposed to make contact w the bed. It was gross, the bed was all stained from the poop, and the pt had to lay in the stained area, which to me seemed so gross and unsanitary, but it did heal the decub. I believe Medicare does cover a clinitron for a stage 4 decub.

    I know duoderm isn't indicated for stage 4, just thought maybe it would keep the wound clean from the stool.

    Has the pt been seen by a plastic surgeon?

    Let us know how it turns out!! Good luck to you, this pt is lucky to have you as her nurse, your concern for her speaks volumes about the kind of nurse you are. :kiss
    Gee, hoolahan, I'm shocked! Our facility used to rent Clinitron beds, and they came with paper "breathable" chux and an extra, washable "sheet" (which resembled the material they use for tents). Even so, we would have pts. with poo in their wounds, and the bed made it hard to position and stabilize them to change the dressings. Plus, I noticed, the folks tend to "run hot" on those beds too. Don't know if that's good or bad, but the air seems to have a warming effect.

    Anyhow, those are just a few reasons why I came to prefer a RIK mattress. It's expensive. But I was so hooked after having a couple of pts who should've had decubs and just never broke down, I had my mom buy one for my dad who has MS and though he's been immobile for years, he's also free of decubs. Of course, they say the clinical indication for that mattress is a stg II or greater, but what are they gonna do now that they're moving away from staging decubs?

    Am totally enjoying this thread, too, BTW. Thanks!
  11. Visit  adrienurse} profile page
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    Stephany, I don't think that Santyl is indicated in this situation, because there is no eschar. It can be a little hard on new granulation tissue.

    Does anyone use Cavalon spray? I just noticed yesterday when I was at the librairy that it comes in single use packages, in cream form (has anyone used this)?
    Does anyone use Allevyn products?
  12. Visit  adrienurse} profile page
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    P.S. No, we have never consulted a plastic surgeon for this patient. She is palliative, and gets comfort care only -- so therefore no aggressive treatments are to be done.

    I think the reason fo any improvements is our excellent CNS who makes a point to come to see her at lease once a week. He has given a wonderful new perspective to this woman's treatment.
  13. Visit  Sleepyeyes} profile page
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    Originally posted by adrienurse
    Does anyone use Allevyn products?
    The Allevyn products are very popular here and I think they work well if used appropriately.
  14. Visit  nascargirl381} profile page
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    We have been using Regranex gel which we have been havig great results on diabetic neuropathic ulcers. Regranex is one of the first recombinant platelet derived growth factor for treatment of ulcers. The gel is applied in a thin layer and kept covered with a dampened gauze dressing. We do not let gauze dry out. In combination with the regranex we use LILT therapy (Low-Intensity Laser Therapy) once we change to a dry enviroment. It stimulates the production of the granulation tissue,.


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