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Coccyx wound left open to air?

Wound   (760 Views | 2 Replies)
by lailadarling lailadarling (New) New Student

113 Profile Views; 1 Post

Hi everyone, 

This is my first post here, I made an account specifically to post this question. I just finished my third year of RN school in Ontario and I have a Summer job in LTC as a PSW. On my third orientation shift I was doing HS care for an elderly woman who had a deep coccyx wound with no dressing (I couldn't see it because the patient was rolled on her side towards me, but my orienter described it for me). I asked my orienter why there was no dressing but she didn't know, and I could have asked the nurse but didn't get around to it. 

I know in some cases wounds are left open to air if there is an infection. However leaving a coccyx wound open to air seems like terrible practice, especially if the resident is incontinent (which this one was). I'm not trying to be that young, naive nursing student who thinks she knows best but I'm just wondering if this is something that is done often, for my own knowledge. 

Thanks!

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87 Posts; 845 Profile Views

It depends on how deep the wound is. Many shallow wounds can just have an ointment or cream. In fact, wound care companies are developing more of these dressing free therapies (Look up Triad cream). If it is a full thickness wound, then it probably should be covered. 

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vampiregirl has 10 years experience as a BSN, RN and specializes in Hospice.

1 Article; 699 Posts; 13,697 Profile Views

Agree, with the previous poster. I've seen some great results with appropriate product selection in some patients!

Years ago I was a CNA at a facility that stopped using briefs at night except under specific conditions and with nurse approval. None of us CNA's thought this would be a good idea... we were wrong. Lots less skin issues and the healing of several superficial wounds occurred. As I recall we also did partial baths/ incontinence care on every patient at HS and applied barrier cream to almost everyone - so there were more pieces to this than just no briefs. 

In regards to the OP questions... other considerations to in regards to this treatment being appropriate would be in the patient is continent or incontinent as well as their ability related to bed mobility (I saw you mentioned this patient was incontinent - I just threw that in to help with the thinking through the process). Positioning the patient to alleviate pressure to the affected area is also very important. 

I encourage you to ask questions when you encounter things like this! This is how we continue learning even as a experienced nurse I still ask many questions and do a lot of research:)

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