MRSA in wound

[bebop1]

Hey...if anyone can help....I have multiple patients with wounds that have MRSA. I am a home health nurse, and of course they send them home....and about a week or two later after we have them...fianlly they are Dx with MRSA.

what is the best sort of wound product to use on MRSA. is any kind of a silver dressing going to do any good on the wound if not on antibiotics? or do the two have anything to do with one another?

any help would be great!

[Boston-RN, RN]

I just checked the bactroban website because I have quite a few patients with MRSA and was curious if it is effective why wouldn't our wound nurse recommend it. Both the cream and ointment are indicated for external use only (not including the nasal product) under the usage recommendations

[CHATSDALE]

mrsa quite a traveler..

one facility i worked at required double-gloving just in case one was incompetent. there was a very aggressive tx stopping just short of isolation procedures...wounds were cleaned, debrided bid -nutrition was monitoreed

there was something that one of the doctors did that seemed to have good luck on a lot of patients an antibiotic ointment mixed with a medicated powder until the ointment couldn't absorb anymore of the powder and this was placed in the wound

rational was that the ointment was assisting in healing and the powder was absorbing fluids and helping to close skin over wound

we had a terrible time with the mrsa spreading from resident to resident in spite of the emphasis put on handwashing between resident and the double gloving but ltc residents walk about and have contact with the entire facility..we finally got a hold of the situation...when we had gone two weeks with no new outbreaks don bought everyone a pizza...unfortuately i don't eat cheese

[Afrolinda]

In my LTC we tend to use silvadine for wounds, get a sensitivity on the wound culture and treat appropriately with PO antibiotics at the same time.

At the same time we start what we call MRSA protocol. It's really new and I was VERY skeptical when it was introduced.

As soon as you know someone is positive for MRSA, we start with all daily bathing and weekly baths are done with tea tree oil body wash for 30 days, at the same time we start bactroban ointment in both nares bid for 14 days. 48 hours after the 30 days of tea tree bathing is complete we do swabs of nares, axilla and groin for C&S one week apart for a total of 3 wks. If all 3 of the weekly tests are negative. That's the end of it. If any of the 3 wks comes back positive, we repeat the whole process again and retest. If any of them come back positive after the second treatment, we stop there and consider the person colonized.

We do this for anyone who tests positive for MRSA from any source and have seen positive results. (anyone else ever heard or done this treatment? Just curious)

I live in Belgium and we use the same treatment for people who are positive for MRSA.