favorite wound products - page 2

by adrienurse

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 decision has been made to do no... Read More


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    I think that aquacel has been tried. Apparently, it dried out the wound base too much. It was abandoned, and now Allevyn square is being used to cover packing. Resident hav sensitivity to adhesive allevyn, so now we cu a 20x20 square into quarters and use that.
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    Try hopping over to WoundTx.com
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    Oh, I forgot to ask. We don't use rectal pouches here. Can you please explain what they are and how they are used?
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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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    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.
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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
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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).
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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
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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
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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.


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