Allergic reaction to dressing change?

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I have a LOL who gets frequent skin tears. Going to do research on better prevention of those this weekend, however, my immediate question is which material from my dressing change do you think would be the most likely culprit for an allergic reaction? I've notice this happen twice after changing her dressing on my shift (usually I change it right before turnover so I hadn't put two and two together). Anyway, you change dressing and right above it she's start itching really bad and get a rash. Not where the dressing is, but right above it. I'm thinking she's allergic to one of the materials, but maybe not? I don't know. Just wanted to pick some brains here. She gets xeroform guaze, telfa, wrapped with Kerlix, no tape comes in contact with her skin. Do you think any of these could be causing an allergic reaction? I'm going to start by leaving out the xeroform and see if that helps.

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I would introduce each one slowly to see which one is causing irritation. Leave the xeroform on for a minute and see if that causes any itching or irritation and then proceed to the next item. Could it be your gloves? Did any of the other nurses happen to notice when the irritation seems to occur? I would also ask MD to order Benadryl PRN.

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Specializes in retired LTC.

First thing that came to my mind, what's the ingredients in xeroform? Had to look it up - there's 3% bismuth triphenobromate in the gauze.

Maybe that's causing the topical reax.

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I would introduce each one slowly to see which one is causing irritation. Leave the xeroform on for a minute and see if that causes any itching or irritation and then proceed to the next item. Could it be your gloves? Did any of the other nurses happen to notice when the irritation seems to occur? I would also ask MD to order Benadryl PRN.

I'm going to try an experiment on tonight's dressing change and see where I get. The rash and itching seem to go away after a while of it being placed.

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First thing that came to my mind, what's the ingredients in xeroform? Had to look it up - there's 3% bismuth triphenobromate in the gauze.

Maybe that's causing the topical reax.

I'm thinking it's the xeroform as well and that's where I'm going to start with my experiment.

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Specializes in Gerontology, Med surg, Home Health.

1. Please don't just 'experiment' on this resident without speaking to the MD and getting orders.

2. Benadryl is on the Beers' list and shouldn't be given to elders....it causes dizziness and increases the risk of falls.

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Specializes in NICU, ICU, PICU, Academia.

If it's truly not where the dressing is- my bet is your gloves.

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1. Please don't just 'experiment' on this resident without speaking to the MD and getting orders.

2. Benadryl is on the Beers' list and shouldn't be given to elders....it causes dizziness and increases the risk of falls.

I wasn't going to experiment with Benadryl. I'm a new nurse, but I'm not a flipping idiot. I know you need new orders for giving meds and I know that Benadryl is on the Beers' list. I was planning to experiment with adding xeroform first and seeing how she reacted before adding anything else.

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If it's truly not where the dressing is- my bet is your gloves.

That's a possibility as well. Thanks for the input.

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Specializes in Public Health, TB.

Adaptic is nice for skin tears, but probably more expensive than xeroform.

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Specializes in LTC, SNF, Rehab.

What are you cleansing her skin with? My guess would be that it's either the gloves or something in the cleanser that is causing her rash. How long do the rash & itching last? I would leave a note for the MD. Are you using skin prep on her? I've never seen a reaction to it, but that's a possibility, too.

If she's allergic to the gloves, I would expect to see her reaction more wide spread since I'm sure the aids wear gloved while providing care.

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What are you cleansing her skin with? My guess would be that it's either the gloves or something in the cleanser that is causing her rash. How long do the rash & itching last? I would leave a note for the MD. Are you using skin prep on her? I've never seen a reaction to it, but that's a possibility, too.

If she's allergic to the gloves, I would expect to see her reaction more wide spread since I'm sure the aids wear gloved while providing care.

Well, last time I did the dressing change she had no itching at all and reacted to nothing. So I don't know. 2-3 times I noticed itching after, but maybe it was just unrelated. For now I'll just watch and see.

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