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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.
- Jul 22, '02 by shygirlTry hopping over to WoundTx.com
- Oh, I forgot to ask. We don't use rectal pouches here. Can you please explain what they are and how they are used?
- Jul 22, '02 by sunnygirl272also 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....
- Jul 22, '02 by hoolahanOK, 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.
- Jul 22, '02 by sunnygirl272if i remember right,
medicare doesn't feel these would be necessary together...Last edit by sunnygirl272 on Jul 22, '02
- 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).
- Jul 22, '02 by hoolahanWell, 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
- Jul 23, '02 by Love-A-Nurseoriginally posted by shygirl
panafil is an enzymatic debridement product. go to: http://www.medicaledu.com/enzymati.htmLast edit by Love-A-Nurse on Jul 23, '02
- Jul 23, '02 by Love-A-Nurseoriginally 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).