dsg won't stay on

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Hi, I am a home care nurse and I have a 31 yr man with spina bifida. He is a paraplegic. He has numerous ulcers in the past with skin grafts. My problems is that this stage III ucler is right at the crease of his buttocks. So he is sitting on it moast of the day. He is out and about and does not want to be restricted to bed. We have been using hydrocolloid dsg but, transfering from bed to wheel cchair pulls the dsg right off. We have tried windowing the dsg with waterproof tape that he uses on his urostomy but does not work. The heat is not helping the situation as he is very hot and perspires. Any suggestions ? Thanks very much Peg Lattinville :o

That can be such a difficult place to keep a dressing. Have you tried applying skin prep first. That might help. You might need to try another dressing such as Allevyn Adhesive but also use the skin prep first.

Yes I have used skin prep. I will try allevyn adhesive. I hope Ma Medicaid will pay. I have asked for a few othr dsg and Ma Medicaid won't pay. maybebe they will go for this. Thanks heaps. Peg Lattinville

They can be soo tricky in that area. When cleaning, make sure the skin is dried, then apply the skin prep,then dressing. Are you able to get help when transfering him...so that you can reduce the shearing that pulls the dressing?

Encouraging him to lay in bed side to side as much as possible.

Specializes in ICU, PICC Nurse, Nursing Supervisor.

How thick is the hydocolloid dressing. There are thick and thin ones. I have had no good luck with the thicker kind and have always used the thin. How is the skin around the wound? Because maybe you could secure it with some mefix tape. But that is only if the skin around the dressing is in good condition. Mefix sticks real good and pulling it off on damaged skin is not a good thing.

Hi, I am a home care nurse and I have a 31 yr man with spina bifida. He is a paraplegic. He has numerous ulcers in the past with skin grafts. My problems is that this stage III ucler is right at the crease of his buttocks. So he is sitting on it moast of the day. He is out and about and does not want to be restricted to bed. We have been using hydrocolloid dsg but, transfering from bed to wheel cchair pulls the dsg right off. We have tried windowing the dsg with waterproof tape that he uses on his urostomy but does not work. The heat is not helping the situation as he is very hot and perspires. Any suggestions ? Thanks very much Peg Lattinville :o
Specializes in ICU, PICC Nurse, Nursing Supervisor.

How big is this wound?

Hi, I am a home care nurse and I have a 31 yr man with spina bifida. He is a paraplegic. He has numerous ulcers in the past with skin grafts. My problems is that this stage III ucler is right at the crease of his buttocks. So he is sitting on it moast of the day. He is out and about and does not want to be restricted to bed. We have been using hydrocolloid dsg but, transfering from bed to wheel cchair pulls the dsg right off. We have tried windowing the dsg with waterproof tape that he uses on his urostomy but does not work. The heat is not helping the situation as he is very hot and perspires. Any suggestions ? Thanks very much Peg Lattinville :o

Another little tip - always apply the dressing from the bottom upwards, this reduces the tendency for it to roll or crease. Might just help :rolleyes:

Tina :)

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