Heather.leah

Yes Unna Boots can be left in place unsupervised for up to a week as long as they are applied correctly. It would be wise to instruct the patient to remove the dressing if they experience pain that is unrelieved with elevation, or have an increase in shortness of breath. Use unna boots with caution in patient's that have known congestive heart failure, since the unna boot is a compression dressing it can cause a fluid overload in some fragile heart patients. Good luck! Where in the DR are you located at? I am hoping to visit there in December doing some medical mission work.

You stated that each time the wounds are debrided they get worse. This can be a sign that the patient doesn't have good blood flow to the area. Without good blood flow, no wound treatment will work. I would check with his physician to see if he has sufficient arterial flow. If he doesn't, then he needs to be revascularized. Another sign of infection is copious amounts of drainage. Has the wound been cultured to check for infection. I have used mesalt on many patients that their wounds were had slough and also on wounds that had healthy wound beds, both types of wounds did experience minimal pain with mesalt. Moistening the mesalt prior to placing it into the wound bed can decrease the pain, but if patient still experiences severe pain and you are unable to manage it appropriately then a different dressing needs to be used. Pain is our fifth vital sign and we cannot ignore it.