Calcium alginate rope...help!

[Neener_RNBSN]

I work in a LTC facility and I have a resident with a stage III sacral ulcer. The order is to irrigate with wound cleanser, pack with calcium alginate rope, and cover with C/D/D once daily and PRN. Since this is still my first year as an RN, I'm still learning, and my question is this: Does the calcium alginate rope need to be soaked in NSS before packing?

I have NOT been soaking it before packing. I was just surfing the internet and saw a question someone asked about soaking a different type of calcium alginate (the answer was no), and I thought, "OMG! Should I have been soaking it before packing?" I can't seem to find this answer anywhere!

I work 3 to 11 shift, and when it comes to wound care, I'm pretty much on my own. I'm the charge nurse...the DON usually leaves shortly after my shift starts, and I don't do the wound care till around 7 pm. There is an LPN who works on the floor below me, but she is also a new grad and has even less experience than I do. Does anyone have experience with calcium alginate rope? Do you soak it or just pack it dry? This wound does not have much exudate. Of course, I can just ask at change of shift next time I work, but I want to know now if possible. Have I been doing it wrong???? (And of course, there are no directions on the box that the rope comes in!)

Any input would be MUCH appreciated!

[nurse2033, MSN, RN]

I believe in the common sense approach. If NS was required, you would be directed by the packaging to use it. I would think that saline would dilute the embedded medication. Don't have direct experience with this intervention though...

[jbudrick, MSN]

The purpose of calcium alginate rope is to absorb drainage. Do not soak it with NS. Cleanse the cound and absorb any excess liquid with gauze then pack with calcium alginate. It should turn to a gel-like mass as it absorbs wound drainage. Calcium alginate can increase the time between dressing changes and absorb more drainage then gauze packing.

Hope this helps.

Diana

[Asystole RN]

No, it acts like a sponge...kind of.

You soak gauze, alginates are dry.

http://www.worldwidewounds.com/1998/june/Alginates-FAQ/alginates-questions.html

https://allnurses.com/wound-ostomy-continence/calcium-alginate-rope-364151.html

[flyingchange]

From an article I found:

Alginates have been shown to be useful in a variety of situation; sloughy wounds which also produce a degree of exudate may be dressed with alginate dressings such as Sorbsan, Tegagen, Kaltostat (or other gel forming polysaccharide dressings). The gel which is formed as these products absorb exudate forms a moist covering over the slough prevent ing it from drying out. These dressings require moisture to function correctly, so alginates are not indicated for dry sloughy wounds or those covered with hard necrotic tissue.

For shallow, heavily exuding wounds such as leg ulcers, fibrous sheet dressings made from alginate fibre may be used, while cavity wounds, traditionally packed with gauze soaked in saline, hypochlorite, or proflavine, are now more commonly dressed with alginate fibre in the form of ribbon or rope.

For epithelizing wounds, alginates have an advantage over cellulose dressings in that they can be removed without causing pain or trauma if they are first well soaked with sodium chloride solution.

http://www.pilonidal.org/pdfs/alginates-questions.pdf

Seems to indicate they go in dry into wounds with heavier exudate and can be moistened to reduce trauma on removal.

I am interested in the other replies you get!

[luvmy2angels]

I have used ca alg alot and you do NOT want to soak it in NS first. Actually i have never soaked any kind of ca alg. Sounds like you are doing everything fine!!

[classicdame, MSN, EdD]

alginate is made of sea weed and acts like a sponge. The purpose is to prevent copious drainage.

[tewdles, RN]

agreed...you are doing fine...the rope is used to absorb drainage.