favorite wound products - page 3

by adrienurse 17,062 Views | 56 Comments

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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    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.
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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!
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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?
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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.
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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.
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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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    Regranex is good stuff, about $500 for a tiny tube too! Fortunately it only takes a teensy bit, that is a good idea though.

    adir, have you seen the newer clinitron beds? I had a pt who had one in the home, I was doing a sub visit for his regular nurse, it was only clinitron-like in the center of the bed. Very cool, but still hard to keep HOB elevated. Gosh! I used to HATE those beds in the hospital!!! Esp if pt had enteral feeds.

    Still though, it is really effective for those stage 4 decubs.

    Did I already mention iodosorb? That stuff is great if the wound is draining a lot too. I absolutely swear by this stuff!!

    You did say in the first post to imagine we had all the $$ we could want to treat this wound!
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    originally posted by lpn,future, rn
    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".
    panafil also is being uses as a cleaner besides being a debriding agent!
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    originally posted by shygirl


    panafil also is being uses as a cleaner besides being a debriding agent!
    i would think because of its cost and depending on the wound which determines how often the treatment is done, this would not be the choice for a "cleaner per say". yet, we learn something new daily. school me, i love to learn.
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    Our facility had this person awhile ago and we used panafil on her Stage II ulcer. At first I questioned it also, but the MD was confident that he wanted to stay with the panafil. It worked! The wound was so clean.the dressing changes were only qd instead of , say BID and maybe the time that it was left on worked. The panafil has a stop action time associated with it. After so much time (I'm not sure of this) it allows the wounds to heal!


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