New wound care work

[zacarias, ASN, RN]

Hello all,

So I'm doing a short-term travel assignment in a small clinic for eight-weeks until I get another job. This is totally out of my element as I normally do step-down tele. This clinic I'm in does wound care; A half dozen or more people come in for wound care appointments every day.

I just wish I didn't feel such like a fish out of water here. The docs are the ones that direct the wound care and some things are strange even to me who has little wound care knowledge. The docs have us clean deep wounds with chlorhexidine and 70% isopropyl alcohol (cringe). Then they have wound vacs and have them changed daily??

Question, I know we don't do wet-to-dry dressings anymore for deep wounds. What do we do instead? Do you put a wound contact dsg like Aquacel and then put dry gauze over that to loosely pack? Or do you moisten the gauze with saline first? How do you know whether to use Aquacel or Puracol?

The nurses there just do what the doc says but I wish I was more informed on what to do. I don't have money to take an expensive wound care course. Please help! Thanks.

Zach Thompson

[Mistyrose123]

I suggest that you go to your wound vac supplier web site. there you will find directions for the wound vac use that will tell you wound vac to be changed 3xw. this will give you the written evidence. also you may suggest that changing vacs less, is cost saving. I am not sure I understand about wet to dry question. but I will try. a wet to dry dressing is placing wet gauze in wound bed up to the wound edge (do not place on intact skin) then cover with dry gauze. wet to dry dressings debride necrotic tissue but also damages new granulation tissue. aquacel is a calcium alginate. again go to supplier web site. this will give you the written evidence of how and when to apply