patient was multiple small sore near perineal area. posterior thighs, but below the buttocks pt has a foley cath and morbidly obese. non ambulatory.
MD classified them as pressure ulcers. But my interpretation is perineal dermatitis secondary to macerated skin d/t her cath leaking for 3 days. sores are there bc she lays on the catheter and it forms breaks in skin. so i guess by that it can be classified as stage 2 pressure sore.
MD order is to cover the area w duoderm... In my opinion, it is not very effective bc the area stays moist due to sweating, etc. and it rolls on the edges due to friction of pt moving her legs up and down etc. pt complains that it is very painful and tender.
what other treatment should i suggest to the MD? silvadene cream?
Nov 15, '11
Quote from wunzieRNBSN
is that safe to put on open areas?
Yes - it's safe. You could also powder with stoma powder after the skin prep. Same effect as a hydrocolloid.
Last edit by finchfamily4 on Nov 15, '11
: Reason: Additional thought
I have got good results from Desitin MAX, which is 40% zinc oxide vs the typical barrier cream that has 13 or so %. I have used stoma powder. Works nicely. I would chuck the hydrocolloid if she is so sweaty that it isn't going to stick. If anything it might trap moisture underneath it. Flander Buttocks Ointment is good for IAD. Try to get her to wear loose undergarments to help circulate air. I wouldn't use commercial cleaning products for bathing if it is severe. Patting with cool damp wash cloth and then patting dry will help not to irritate. Also if you are using barrier creams, make sure staff knows not to rub it off. But to just take off the top layer and reapply.
Last edit by PsychNurseWannaBe on Nov 15, '11
: Reason: typo