Hi, tried posting this on the wound care forum and got no response. I guess they think I'm a nursing student.
or a total idiot! Anyway here's my problem 2 actually.
1 new admit with gangrene to the scrotum, I haven't seen him yet to assess, but I assume it's dry gangrene and his condition makes it a non-surgical option or he just wants comfort care. I'm hoping that it's been a surgical intervention or involves just the top layer of skin, but I am scared. My last pt with gangrene to the great and 2nd toe was a Hospice pt, we just painted it with genitian Violet. I know others use betadine. Any other products used for this type of problem? I read the thread on wound forum regarding dressings for the scrotum so I have a clue if I need a dressing. Anyway. any thoughts, experiences would be helpful.
the second is a pt who has developed a punched out "hole" on the skin of his member from repeated
pulling at and pulling out of his foley. Obvious answer pull the foley, not an option.
MD wants it in, so does family???? We have been applying a small dressing that has a
gel like quality on the dressing side, per wound care suggestion. Keeping it on is a challenge,
I'm wondering about applying hydragel with cath care and just keeping it open or bactroban.
any simular experiences? Any advice would be helpful thanks.
I have a pt who is NOT a hospice pt, but has experienced a domino-like cascade of problems in the past month. The most recent was a four day period where he was obtunded and only responsive to pain, but all of his tests (xrays, ct, eeg, etc) were normal or "no change from previous" (when he was up and talking). Last week we were cleaning him up and I noticed that the tip of his member was black. Told the Dr who got a consult - it was diagnosed as dry gangrene. They aren't doing ANYTHING about it. Can that be right?? It's gangrene for heaven's sake!
decisions should always be based on pmh, comorbids, overall health, and age.
if pt would be high risk/poor candidate for surgery or any aggressive txs...
leslie :-D
11,191 Posts
decisions should always be based on pmh, comorbids, overall health, and age.
if pt would be high risk/poor candidate for surgery or any aggressive txs...
then their decision would be based on above.
leslie