Help! I have a difficult wound to dress today!

[YogaloverRN]

Hey everyone, sorry to write so early, but I suddenly realized that with you all I have a great resource for these two difficult wounds I have to dress today. This patient has bilateral groin wounds which have severe tunneling. We had a wound vac on these wounds but now the patient developed a yeast infection and the entire groin areas are excoriated. I havent actually seen the wounds yet, but the nurse who dressed them yesterday said she couldn't keep the dressings on since there is nowhere to secure the dressing, any ideas? Could we use clean cotton panties to keep the dressings in the groin area? I know plastic surgery used to use some type of corset device for difficult to dress areas didn't they? Any advice would be GREATLY appreciated!!

Thanks!

[johnst10]

Depending on where the actual site is the panties may work. I think you might be talking about Montgomery straps for the corset. This would probably not work because it has to adhere t something. If it is lower groin maybe you could use an ace doing an S wrap around the legs and up to the waist. Good luck!

[YogaloverRN]

Thanks Johnst,

Well, I saw the patient and the area is right in the crease of the groin on both sides, tried secure by wrapping kerlix rolls around the top of the legs, and taping reinforcements up legs, by 7 pm I had to go back because she got up to bsc and the dressings fell down. Arghhh, I thought about mens boxer briefs since these go down the legs a bit, but again the issue of toileting is a problem. Gosh she has only 1 kidney so the doc doesn't want a foley, this is the hardest case I have ever had.

[Duranie]

Try using elastic net "panties". They are frequently used in OB. They will hold the kerlix in place and keep it from falling down. To address the toileting issue you can cut the netting to create an open crotch. Just be sure to make the cut a lot smaller than you think you need because it will stretch. You can always snip more later to make it just right.

Depending on how far down the thigh the dressing needs to extend, you may need to use standard elastic net bandage retainer to hold the thigh portion.

Good luck