stage I, II, and a III

  1. first I want to say...this website is wonderful. sometimes I feel like the nurses I work with are in a contest to see "who is better" and thats not me. I am in nursing for a reason...to take care of patients....not to be better than one nurse or the other. so when I ask a fellow home health nurse her opinion...she makes me feel like I know nothing...and should leave...when in fact I have been in home health 3 years longer than them, and want other view points to increase my knowledge base! anyways...

    I have a pt that has three pressure sore...right on the top of the crack of the buttocks. I am not sure if that is the proper term. but she has a stage II on the left side, and then a stage I and then a stage II right below that. none are connected, they are all real small, I am not sure on how and why they are all different stages, but they are. I have tried duoderm, extra think duoderm. the caregiver says "it just folds over and gets ruined." the patient is a CVA patient, Left side weakness, and sits in her scooter all day. I have tried to get her to stay in bed more...which she doesn't even get in bed, she sleeps in recliner! so thought get her a hospital bed, she will not agree. They refuse, home health aides, Physical therapy, only really will let myself into their home. I was going to maybe do a hydrogel? dressing? but not sure on how to keep it on the area? or what would anyone else recommend?

    thank you!
    emily:spin:
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  2. 5 Comments

  3. by   lezliyloo
    Yeah, I know that's a lousy location for dressings. Have you considered xenaderm? Beyond wound care, do you have her on an air cushion of some sort? Pressure relief exercises? Nutrition?

    Just some food for thought.
  4. by   bebop1
    what are the pressure relief exercises? I am not sure of those things?
    And she sits in a scooter, and I am under the impression medicare will not cover any sort of pressure relief, or cushion due to she has a scooter? I will look into xenaderm. the doctor wants us to do whatever we think will work. and we are trying everything we have. and trying everything we have to keep it on the area!!!

    thanks!
  5. by   sharlynn
    I've had good results with Xenaderm in that area. Sacral crease is a better term.
  6. by   nurselearner
    Even if medicare will not pay for an air cushion they are usually less than $25 and can be purchased in some drug or medical supply stores. Shifting weight side to side (rolling hips up) helps relieve pressure. Barrier spray and paste work well when dressings don't. Tell the family that despite these measures the patient is at risk for further breakdown and document it all!
  7. by   iamarn
    Have you tried the thin duoderm spots? have had luck with them before.

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