Another duoderm question. . . .

[kcalohagirl]

I know there was recently a thread about the drawbacks of using duoderm to cover blisters.

I had a LOL come up to the floor tonight w/ duoderm covering a small (1/2 cm) skin tear on her arm. I could see a small amount of fluid pooling under the duoderm, so I took it off, cleaned it up, and used tegaderm to cover it instead, (thinking I'd have a better look at it if there *was* fluid poolin under it, at least tegaderm is clear, so you know to get it off, clean it up, etc.)

What do other people do for small skin tears like that?

[Tweety, BSN, RN]

We use the mepitel dressing I mentioned in the other thread.

Duoderm and tegraderm used to be the standard for these things. Now I think the latest it's better to have somewhere for the drainage to go, rather than sit behind a tegraderm.

I'm no expert however.

[nurseKim28590]

i don't use tegaderm because when i take it off it just re-aggrivates the wound. i use duoderm. duoderm is used for lightly draining wounds. it's alright to have drainage underneath. duoderm wicks it out. leave it on for the five to seven day window that it is intended for and generally your small wound is healed.

[all4schwa]

although it does the trick, i've always despised duoderm. I cant stand not being able to see the wound and if it does come off before it's time, it's very harsh. Plus, I just think the dressing that comes off is plain yucky. if it were draining, i probably wouldn't have put tegaderm on it either....i guess it would just depend on what it looked like vs. what I had on hand.

[Tiwi]

Mepitel is a wonderful product. It's only just started being used here. I still prefer duoderm to Tegaderm though, because if the blister is still oozing Tegaderm falls off straight away. What I hate about duoderm, particularly if the pt is relatively immobile, is when it curls up and increases the risk of pressure points, as well as being difficult to remove.

[Cindylufus, BSN, RN]

If you pull on the edges of the duoderm, it will curl up on itself, making it easier to take off....It works for me! Do any of your hospitals have a skin car protocol? We change dressings, photograph, and measure wounds on Mondays and Thursdays. I was wondering if this was the standard?

[talkhateeb]

i prefer to use mapore (primapore), because it has a foam which means the ablility to absorb alot of oozing. on the other hand, its easy to remove and not harmful on the skin. Its a white dressing, so if its full of pus or blood you can see it from outside before you open the dressing.

im wondering why you will use tegaderm or duoderm while their are not absorbing this much of drain?

[TracyB,RN, RN]

I love using Xeroform!! That stuff is great, as is PolyMem (pink foam dressing that is like a sponge)

[jimthorp]

What do other people do for small skin tears like that?

Dry dressing like a minitelfa. Change q3-5 days and PRN until healed.

Managing exudate is not the only consideration for wounds. Temperature is also important. Changing a dressing too often disrupts the temperature of the wound bed causing delayed healing.

[Antikigirl, ASN, RN]

I have dealt with small skin tears with approximating as best I can, using steri strips, and if draining I will use a telfa with medipore tape till the drainage stops, then keep open to air (dependant on where the skin tear is...don't want to keep open to air in a place that gets sheer or body fluids on it like the upper thighs or groin or skin folds).