Duoderm, Tegaderm, Wet Gauze

Nurses General Nursing

Published

Which or what else do you prefer for a sacral stage II in a very immobile, bed-bound patient? What do you suggest? Any treatments with which you have successful outcomes? I would really like this to heal.

Thanks.

Specializes in jack of all trades.

Boy did this bring back some old memories - anyone remember when we used Maalox, taped the buns to the bedrail with a heat lamp? We've come a long way in wound care!!!

Specializes in Vents, Telemetry, Home Care, Home infusion.
hi, applying skin prep after wound has been cleansed and dried provides a protective covering "almost like a second skin to the wound helping to prevent maceration from incontinence", also there is a dressing called allevyn, it has a very fluffy cushion which helps to offload the pressure in those tricky areas, if your facility does not carry it , ask your manager to give the company a call they are always glad to send free samples, this way you can try it out. good luck.

another vote for allevyn especially on coccyx area due to cushion center: changed q 3 -5 days like duoderm.

duoderm if left on too long too will dry and crack-can cause friction underneath. q3-5day change is standard in homecare.

does your facility have a wound care formulary which has standardized products for different wound classifications along with p+p for using selected products. helps standardize care and decrease cost to facility.

since our cetn staff developed our formulary, costs went down, length of time to heal wounds decreased and consistency amongst caregivers achieved. yearly wound care in-service along with quarterly update at staff meetings helps.

those with incontinence, good old fashioned a+d ointment as skin protectant. urine burns or chafing received balmex ointment or boudreaux's butt paste as skin barrier ointment.

tube fed can by placed in side lying position for at least an hour with good pillow support., notch foot of bed up slightly to prevent sliding down and shearing forces.

Thanks, Karen.

Specializes in COS-C, Risk Management.

Nothing to add to the suggestions, but thought I'd throw this article out there for review:

Hanging Wet to Dry Dressings Out to Dry

Nothing to add to the suggestions, but thought I'd throw this article out there for review:

Hanging Wet to Dry Dressings Out to Dry

Kate, thanks! I just emailed that to myself at work to make copies and give to the DON. I HATE wet-to-dry.

Karen, I have no idea where the P&P are. I've asked.

Specializes in Med/Surg, Home Health.
We've had really good results with hydrogel and Permafoam (similar to Allevyn I think). If the edges are a bit macerated, we do use skin prep.[/quote']

I agree. We apply multidex gel (if its a dry wound) or multidex powder (if it has drainage) and then apply skin prep on the periwound and apply the allevyn over it all. The allevyn stays on for 3 days (I think, it may be longer). Ive had excellent results with it. Its what our wound care clinic recommends and it works wonders. Ive had skin tears heal in half the time using this combination. But with incontinent patients, its hard to get anything to stay on, but skin prep helps it stick better and protects skin. I hate bed sores, Ive seen some HORRIBLE ones and they have to be painful for the patient. I hate depends or pullups, they hold in moisture which makes it worse. I try to use chux to try to keep moisture off skin.

Specializes in Surgical, quality,management.

what about mepilex border?? It is the P+P dressing for a pressure wounds in the hospital I work at. I think the hospital rational for that over comfeel (duoderm) is the bunching and rolling that happens with duoderm.

I'd definatly bring up with the MD about increasing the rate in order to have a few feed free hours so that he can be side-lying. Or how about tilting with a few pillows under one side of his body so that the pressure is off the wound a little?

If you only have 2 CNA's on nights make sure that there are slide sheets at the pt bedside because bedsheets are NOT for sliding pt up the bed on. (pet peeve)

Good luck because if he is dying you dont want him to suffer a pressure sore. Not that there is a good time for one but you know what I mean!!

Specializes in Psych, LTC, Acute Care.

We used deoderm at my last place. The have to be changed every 3-5 days per our protocol or sooner if there is moisture that seeps onto the pad. We packed the wound bed with this material in a foil container. It would turn to gel when it got wet. Forgot the name of it. Good luch on the wound.

KateRN1, I found out we have a wound care specialist and she refers to the article you linked all the time!

She also said Allevyn is very expensive and we use Optifoam, from the makers of Duoderm. They should be changed Q5D MAX, and checked QD.

The resident in question was sent to the hospital over the weekend. If/when he comes back I am going to see if we can up his rate to allow him 4 hours QD off the tube so he can digest for an hour and then lay flat for another 2x a day. It should do a lot to alleviate constant pressure in one spot.

Wound care on my unit is being revamped.

Thanks for all of your input. I appreciate it, as do my residents.

:)

SuesquatchRN, I sure hope you're working when I'm put into a LTC by my kids.

Can I put that in my living will, "SuesquatchRN only to case manage my care"?

SuesquatchRN, I sure hope you're working when I'm put into a LTC by my kids.

Can I put that in my living will, "SuesquatchRN only to case manage my care"?

:D

Tell your kids that if they put you into LTC you're going to come back to haunt them.

:D

Tell your kids that if they put you into LTC you're going to come back to haunt them.

I think I have to worry more about the wife ditching me there, than the kids. LOL
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