gout wounds

[HHNurse<3]

I have a patient with extensive skin breakdown on both legs. The patient has erruptive gout but pt/md unsure of wound origins. This patient has a history of amputations of multiple digits. The wounds on the legs are clustered and not that large but the skin surrounding the wounds looks awful. It is reddish/purple and peeling. We have been using xeroform with kerlex after washing with soap and water 3 times/week. When we first say him there was a huge amount of dead skin build up. After thoroughly cleaning for a while, the dead skin has mostly been removed. But the skin is still discolored and the wounds are scabbed over now. Does anyone have recommendations/experience with this type of situation? Should the xeroform only be applied to the wounds? Or to all the affected areas?

Thanks!

[RN1989]

If you put xeroform on areas that are not broken down, the wetness of the xeroform will cause in increase in skin breakdown.

If things are scabbed over now, it may be time to stop putting xeroform and simply a dry dressing to protect the scabbed areas from getting ripped open by environmental factors.

For things of this type, my fave wound doc taught me that being dry is generally better than being wet.

Have you considered fungal/bacterial cultures for these wound?