I have a bed bound patient who has very red excoriated skin on her back and buttocks. What is the best treatment for this? I have used duoderm patches to heal open skin areas but now patient has no open skin areas. Any help and or suggestions?Thank you
RachRN11 38 Posts Has 5 years experience. Jan 26, 2015 You could try barrier cream or maybe it's a yeast infection and needs some nystatin.
icuRNmaggie, BSN, RN 1,970 Posts Specializes in MICU, SICU, CICU. Has 24 years experience. Jan 26, 2015 If the skin is denuded from incontinence dermatitis, wash gently and rinse well, pat dry, apply karaya powder and then calmoseptine. Remove only if absolutely necessary with 4X4s and baby oil.These are the manufacters recommendations for protecting and healing incontinence dermatitis.
Deborahkrn 3 Posts Jan 30, 2015 Thank you for response/advice...I appreciate it....is the karaya powder and calmoseptine products available without a script? Can I order them through a med supply co?
Here.I.Stand, BSN, RN 5,047 Posts Specializes in SICU, trauma, neuro. Has 16 years experience. Jan 30, 2015 You could also try using a flat sheet as a bottom sheet. That way as the pt slides down in bed, the sheet slides with them. If they're on a fitted sheet, the pt can still slide down in bed, but the sheet stays put, creating friction/shear.Also make sure the skin is moisturized; dry skin is at risk for wounds, just like skin that sits in a wet brief is at risk. Be vigilant about adequate PO intake, and use lotion--just make sure to rub it in so she's not lying in the moisture. And hey, maybe the rubbing will stimulate some good circulation to the area. It sounds like you must be doing some things right though, since your interventions healed up the open areas.
Gooselady, BSN, RN 601 Posts Has 23 years experience. Jan 30, 2015 We had an 'adult diaper rash' cream at my last job, it had zinc oxide, moisture barrier and calazime cala-something in it that made it that off-pink color of PeptoBismol. A thin layer over a cleaned and dried peri-area, including 'inner' areas on females was FAST at getting that macerated skin to replenish the top layer. It worked so well that we were always getting dinged from the Wound RNs for using too much of it and too often, or applying too thickly. More is not better with this stuff. Also, a simple diaper rash cream for babies is good for adult bottoms, too.
