Question on cleaning fragile wounds/burns/grafts

[itisisntit123]

Hi.

I'm not a stranger to wound care, but I thought I'd pop by and ask a question.

I was doing a xeroform dressing change on an eldery lady whose leg is completely covered by venous stasis ulcerations.  I remove the old xeroform by slowly peeling it back while shooting NS under the dressing simultaneously as to not damage the wound bed, but once the xeroform is removed, small, yellow, xeroform pieces/debris needs to be cleansed off the leg. 

I generally try not to do any scrubbing of these types of wounds w/ sterile gauze because of their fragility, but soaking the leg and shooting it w/ NS syringes did not work very well in removing the debris.

Should I use more a larger syringe of NS capable of more pressurization in the future to try to get the old xeroform debris off a wound similar to this?

In the same vein, how do you recommend cleansing medical debris (pieces of old dressing, xeroform, old antibiotic creams) off of fragile wounds like graft sites, burns, etc?  Again, I'd assume scrubbing of these types of wounds is contraindicated.

Thanks!

 

[HiddenAngels]

Hey, I haven't had a burn patient in a while.  The doctors usually ordered plurogel which we had to order along with a light wrap.  I always used a pour technique when removing, old dressing, but the pt was not mobile.  Is perhaps your wrap technique too tight hence leaving the little yellow strings?