packing wound not healing. Advise?

[prettynurseL]

Long story short I just took over a tx position and am feeling the pressure because the prior nurse "made the measurements look good" and my (honest and verified) measurements were "off" so im now im looking for new tx options to heal up the. I have a pt who's packing wound is expanding, using iodoform. Wound md consults but seems to not be bothered that tx ordered months ago is obviously not working. Please help with suggestions, Good wound care books, Sites, etc.

Thanks

[loriangel14, RN]

Wound vac maybe?

[mattthemurse]

I'm a new Tx nurse as well, three months in. Try Aquacell Ag. It worked waaaaayyy better than Iodoform

[prettynurseL]

I'm a new Tx nurse as well, three months in. Try Aquacell Ag. It worked waaaaayyy better than Iodoform

Thanks will try. Right now im doing packing with collagen matrix but theres not much change

[Jeanniejayne]

Hi Prettynurse,

Can you tell us a bit more about this patient? What type of wound is it? Was it post-op? Is it possible it is a fistula? What condition is the patient in? Good health? Diabetic? Anemic? Age? Thin? Overweight? Active? Who is physician ordering care? How long has this patient had the wound? And please describe it: where it is, type, what the tissue looks like, smell, exudate type and amount, depth of wound, associated pain, what does periwound area look like? Has it been cultured for infection. All of these factor in when choosing a dressing. Hang in there!

[taggart84]

I had an abdominal wound pt that had an incision open up. We did a wound vac for a few months then switched to aquacell ag. It's been amazing to see the aquacell work. We aren't packing it per se because it's not tunneled, but lining the wound with moistened aquacell and covering with dry drsg.

[Davidaugustyn]

I agree. More information. If no slough, VAC it!

Not over packing right? just throwing that out there....don't stuff, fluff.