I am a HHN with a pt with non healing wounds on both feet. Long history with the wounds and wound care has been changed to and from every product I can possibly think of. Aquacel, prisma, promogran, iodoform, accuzyme, mesalt, foam dressings, the works. Wounds drain copiously (saturate dressing and socks daily no matter how bulky the dressing) and aside from when they were surgically debrided look terrible and consistently have a shiny gray/opaque wound bed... however they are shallow and not a candidate for the wound vac either. Current tx is daily mesalt (this is the ONLY product that has remotely debrided the wounds and semi-contained the drainage) but the patient barely tolerates the dressing change. As soon as the mesaul is placed in the wound beds, he is in excrutiating pain, pulls away, kicks out and screams. It takes 5-15 min for him to be able to tolerate completing the tx and he continues to appear to be in severe distress through the entire visit. The man is nonverbal, old CVA and very proud and stubborn. Very often refuses pain meds before tx, even tylenol. I'm wondering if anyone has any other suggestions for wound care and/or pain management with the mesalt. I'm at a total loss for what else to do and this poor man is in so much pain... Thanks!