Ideas for non healing 1 cm coccyx tunnel?

angelalofton · Jul 24, 2010

Moisture, nutrition, hydration, and mobility. These are CMS biggies. What this means is that you have to keep the area dry. Put them on a 2 hr potty sched., keep a moisture barrier in place. The must have increase protein and fat to heal. Try making hot chocolate with 2cal. We also used a product called magic cup. (Tastes like custard doesn't melt, packed with fat and protien, and the resident love it.). Mobility, use a turn schedule, walk to dine program, take to more activities and exercise programs. Hydration monitor there I & Os, put them on a weekly weight program. Also sign them up with a nutritionist consult, and or a psych consult. Depression could lead to poor eating and just not wanting to get up and do things. Look at their seat, does need to have a cushion? We healed and prevented many pressure ulcers by using a Wal- mart memory foam cushion. Use a water proof cover.

jamie109 · Jul 26, 2010

Thank you. This resident is very mobile, but has spinal changes which have resulted in internal pressure to the coccyx. I will focus on the protein & fat, but she does eat well. Currently taking vitamins daily, well hydrated.

Chris81 · Jul 31, 2010

Don't forget pain management. During a survey, we had a PT/WCC perform a dressing change on a pt. who stated "OUCH", with the surveyor present. Needless to say,we recieved a MAJOR citation,which resulted in a change in policy/procedure. We now make every attempt to pre-medicate prior to dressing changes,explain we'll suspend procedure until adequate pain relief obtained(yes,this will take time), and document the above on the Wound Doc. Alternative measures-ice,massage,topical analgesia,etc. can be utilized,as well as PRN po pain relief. Maybe short-term routine analgesia for duration of wound? With upcoming changes to MDS 3.0,attention to pain/relief is an essential component. Good luck!