Quote from limey
Pt. has what looks like blood blister that covers the entire heel of one foot. Kept wrapped to protect from breaking. Week later, the area is broken open around blood blister. Is it to be staged like a pressure ulcer? The dead skin is still attached around part of the area. Right now, we are just keeping it dry and wrapped to protect it. What is ideal TX for this type of wound?
Any fluid filled blister while intact is usually already considered a stage 2 ,( some might say unstageable, but our protocol is stage 2, unless there is eschar involved). The blister now open, stage 2 depending on depth, which is prob what you now have, as you describe. Now that it is open, you need to focus on preventing further tisue damage, and /or infection. Depending on the drainage, if scant, I would use a thin hydrocolloid dressing on the heel and offload, offload, offload. Change this dressing every 3 days and prn if drainage comes to borders of dressing or otherwise becomes compromised, ei... wet, soiled or peeling off. If no improvment at your next weekly assessment, or you see it progressivly getting worse, change your orders. You could also try hydrogel in wound bed, covered by foam gauze or other dressing of choice. But keep in mind, the type of dressing you use will depend on how frequently you change it.