Breast CA wound care

[cbski]

Need some advice. Have a patient with ES Breast CA. She has multiple ulcerations to her L axilla that are draining. We have used foam dressings, abd pads with non stick telfa, polymem but it is VERY difficult to get anything to stay in that area. Any suggestions on wound tx that would stay (tape comes off)? Found daughter wrapped her sternum with ace bandage to keep dressing intact but it still came off. Any advice would be greatly appreciated!

[westieluv]

I had a patient like this last year. The only thing that worked for us was to use several ABDs and wrap the whole thing with one or two rolls of Kerlix gauze wrap around her entire body. Even at that, the pt's daughter had to be educated on how to do frequent dressing changes or we would have been at that house several times a day. The axillae/upper chest is just a hard area to dress because of natural body oils, sweat, and natural drainage caused by the pt. being in an upright position.

[leslie :-D]

yep, you need to get creative with a roll or two of kerllix.

over, under, across, diag...whatever it takes to secure.

even making a sling type dsg, where it wraps around neck, has also worked in a pinch.

these types of lesions are usually very nasty...the fungating kind.

they smell, they aggressively eat through the pt, lots and lots of drainage.

lots of ca alg packing, top abx, covered w/abds and wrapping.

peace and comfort to your pt.

leslie

[netglow, ASN, RN]

Those cheap and very thin solid colored long sleeved t-shirts at Target I think Merona brand, They are so thin and cotton and are meant for layering and are stretchy but they are also more closely fitted. They are often on the clearance racks. They are not something that will cause sweating.

You could try to put on from hand, up arm and then over head on bandaged side. or cut an arm to suit, etc. You can wash them or toss them. Maybe buy one size smaller.