Pressure ulcers on buttocks

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I am a Home Health nurse. I have a patient with MS who has redeveloped 2 pressure ulcers on the inner gluteal fold. I am trying silver polymem but would like to know if anyone has a better suggestion. Also if I continue using these should this be changed like on mon wed and fri or should it be less? There is not alot of drainage. any advice appreciated.

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Calcium alginate with silver(AG) would be your best bet with a recurrent wound with lots of drainage. Change 3x a week & prn for soiled.

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Specializes in Wound Care , Foot Care,and Geriatrics.

Hi mymarie,

How long have the stage 2 been there, and, are they getting worse or staying the same?

Is she incontinent, or cathed? Is she mobile or w/c dependent? Has o/t been involved to evaluate for offloading? How is her diet?

For me, what we are putting on the wound is a part of the wound puzzle, as wounds and their etiology are so complex.

Silver needs to interact with fluid; if there is not a lot of drainage you may re assess cutting back to 2x/week as per drainage, we want to maintain moist wound healing in concert with addressing the bioburden, which silver does, and Polymem.

Is she on Predinisone or any other corticosteroids? Diabetic? Being autoimmune compromised blunts infection presentation as well...

That is a difficult area to treat: I would re evaluate at 4 weeks, after that if things are not improving I would augment the Wound Care plan. Are you measuring the area?

How often is she showering? That is another challenge: wounds need to be in good balance with not over drying the skin and over changing the area.

Keep us posted; once we know more that will help us all chime in with more info! MS peeps usually have lots going on :)

Regards,

Follow Your Bliss

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