Skin breakdown-abdominal folds

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Help!!! I am seeing a patient who had a yeast infection in her abdominal and groin folds and now has opened to a thin line of breakdown. The ALF was using Nystop powder but since the area is warm and moist, it would turn wet and clump the powder. Now the area is opening up and I'm not sure how to treat it. Someone suggested Nystatin cream but I'm not sure this is okay for an open area.

This lady is also a diabetic, on Amaryl.

Any help is truly appreciated!!!

Thanks!!

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Specializes in Complex pedi to LTC/SA & now a manager.

Have you requested an order for a wound care consult or an ID consult? It's possible a culture is needed. Theoretically fungi don't become resistant to nystatin unlike traditional antifungals like clotrimazole, but that doesn't mean it's effective against all fungi.

Have they put a moisture wicking physical barrier and practiced diligent skin care, even washing with Johnson's baby wash or saline several times a day? I know sometimes a physical barrier whether thick gauze or even soft towels to keep the area dry with nystatin powder helps prevent the escalation to open wound/breakdown.

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Specializes in corrections and LTC.

This is more for personal knowledge as facilities won't let us do this as we might 'burn' the patient. Using a blow dryer on those areas 3-4 times a day, low to medium heat for 2-3 minutes each time works miracles, clears the areas up in 1-2 days.

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If it's already moist I would steer clear of any cream or ointment. It will only contribute to the moisture problem. I have had patients use guaze or soft washcloths to help separate skin folds with success (and continue Nystatin powder). Using the blow dryer sounds like a good idea!

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