Trying to get ahead of the curve for a home care client with recurring skin tears on arms. Skin tears are often caused by poor transfers, sometimes an Aide and a family member will struggle with a transfer from bed to W/C, the client will struggle a bit to help or resist, and 1 cm to 2 cm skin tears on forearms and biceps recur weekly.
I'm an Private Duty Aide taking the case 7 days a week for a while to get family members and client comfortable with a daily routine including Hoyer use. Generally the goal is to just get some consistency/continuity of care and some overall improvement in aging in place.
Policy and care plan encourages bathing and moisturizing skin. When transparent film dressings, e.g., Tegaderm, Opsite, are already applied to wounds, how careful do I need to be with applying skin moisturizer to surrounding intact skin? Do I need to choose a non-oil-based moisturizer? Should I try to coordinate with the Wound Care nurse so that I don't apply moisturizer right before he/she arrives so dressings can adhere to the skin? I don't work for the Home Care Agency providing wound care so that may not be doable. Just how durable are transparent dressings when inadvertently exposed to skin care moisturizers.
Sep 22, '11
Can you put the dressing on first then carefully moisturize around the dressing? I'm not sure skin prep will work over moisturizer. In WC, I dress the wound and a lot of the time, the patient will ask me to put moisturizer on so I just go around the dressing.
You can put moisturizer on before the patient comes to WC. We clean all wounds before treatment, we will just wash it off; but if their appointment isn't until much later than the time you moisturize, why not put it on?
Sep 24, '11
Quote from Nittybelle
Can you put the dressing on first then carefully moisturize around the dressing?
The Transparemnt Film Dressing would already have been applied, sometimes the previous day, before I see the client. I am an Aide.
Quote from Nittybelle
I'm not sure skin prep will work over moisturizer. In WC, I dress the wound and a lot of the time, the patient will ask me to put moisturizer on so I just go around the dressing.
Was able to reach an RN, BSN, CWOC who stated to me that applying moisturizer over Transparent Film Dressing such as Tegaderm or Opsite is not a problem for small areas on arms as described. The answer may be different for other body areas. It's best to ensure surrounding skin is well moisturized to prevent future skin tears. Wipe away any excess moisturizer from Transparent Film Dressing with a soft, clean, dry cloth.