Skin Prep and Duoderm

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Has anyone ever used the skin prep pads under a duoderm pad? I'm new to HH, but I went out with the HH nurse last week. There is a patient with a stage 2 on her sacrum. They are having problems with the duoderm peeling off. She is bedridden, and is not moving around a lot, so it's not from that. In my opinion, it is from the wound drainage. Not much, but enough in my opinion to keep the duoderm from staying on for the time needed. In essence, it's getting pulled off everyday, and is making things worse. I suggested some sort of absorbent dressing. But HH nurse used skin prep to try to keep the duoderm in place. I've used skin prep with dry dressings to keep them in place, but never seen it done under a duoderm. Will this help or should we try a diff. course of action? I was merely observing that day, so didn't want to step on her toes. But to me the duoderm just didn't seem to be doing the trick.

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Specializes in LTC/hospital, home health (VNA).

I have used skin prep under Duoderm with okay results. But, if the Duoderm is not working/staying on then it probably is time for something else. I hate those darn sacral ulcers...so hard to get anything to stay! I have used Calmospetine and covered with with saran wrap to keep it on...if there is a caregiver to frequently reapply it as well as frequently turn/reposition her. Allevyn is another one that may work if it will stick for you. But yes..as long as the skin is intact or only very superficially irritated skin prep is okay -if the skin is irritated maybe use the non-sting skin prep. But often the biggest battle for the patient is emphasizing and re-emphasizing the repositioning atleast q2 and making sure the caregivers follow through with it :bugeyes:

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Specializes in ICU, CCU,Wound Care,LTC, Hospice, MDS.

I always use Skin Prep with Duoderm and sometimes cover it with Tegaderm or Opsite to keep it from rolling up.

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Thanks guys! :up:

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Specializes in Range of paediatric specialties.

I use skin prep with duoderm or allevyn adhesive on children's wounds particularly incised and drained abscesses I use hypafix or flexigrid in strips around the edges to reinforce and find that dressings stay on for 3-5 days.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

Sometimes using Dudoderm THIN wafer, instead of regular product works better ---seems to slide better over sheet when pts squirming or being repositioned. Definately use skin prep and WAIT till it drys + becomes tacky key too, cover with dressing.

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Specializes in Med-Surg, Wound Care.

We've also had great results with using a tegaderm over the duoderm. It stops the edge rolling.

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I dislike duoderm intensly! When the edges roll, they cause more pressure. Also, isn't using something like tegaderm defeating the purpose? Duoderm is a permeable product, the tegaderm over it would be counterproductive. Also, duoderm shouldn't be used if there is drainage. Have also had duoderm tear skin when removed, especially that "old people" thin skin.

The allevyn, if there is drainage becomes too wet, can really cause masceration.

Those sacral wounds are really tough. Especially if they are incontinent.

Sorry to be a Debbie Downer, but those have been my past experiences with those products.

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Specializes in ICU, CCU,Wound Care,LTC, Hospice, MDS.
........ Also, isn't using something like tegaderm defeating the purpose? Duoderm is a permeable product, the tegaderm over it would be counterproductive.

Tegaderm is air and gas permeable also.

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Tegaderm is air and gas permeable also.

Thanks! This site is great!!!!!!!

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Sorry this is so late gettingupthere, but I think you were right the first time. I think layering them would still reduce the gas permeability. Both Tegaderm and Duoderm are intended to be the only dressing, and you are effectively making it twice as hard for air to pass through by layering them, even if both are gas permeable. This would be very bad for infected wounds. I heard the practice of layering over gas permeable dressings slammed at a wound care course recently, I'm not sure if it was duoderm and tegaderm specifically. Though we were told 'if in doubt contact the manufacturer'. I suggest you do if you are using/thinking of using this practice.

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Umm, sorry. I don't think Duoderm IS even gas permeable, though I know tegaderm is. Actually I have found evidence it is not semipermeable from australianprescriber and emedicine: Medscape: Medscape Access

Current concepts in wound dressings - Australian Prescriber

I can't see where it says semipermeable or gas permeable on the convatec site either.

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