spider bite wound care question

Home Health Columnist / Guide · May 24, 2005

Staff sometimes pack a wound too tightly forgetting that some absorbant products when pulling fluid from the wound puff up and expand causing INCREASE in pressure on tissue exactly as you've described.

Most tunnelled wounds need to be lightly packed, not stuffed full (like sauaage is in casing) to allow for wicking action of fluid and dressing expansion.

NEVER use kling with elastic as seen this cause tissue necrosis in matter of few hours too.

Don't have wet-to-dry dressings soping wet either, wring out excess, as can cause tissue maceration/ bubbling. Don't forget that staph wounds can form slight gas if active infection that causes swelling too.

Traveler · May 24, 2005

Brown Recluse bites can be nasty. Their venom has the same properties as pit viper snakes (copperheads, rattlesnakes, etc.) Their venom digests the tissue so you need to watch for this. I had a patient who had to get hers surgically debrided and then we had her for a while on a Wound Vac which worked wonders. You can't have any necrotic tissue with the Vacs though. Other than a Wound Vac, something like Aquacel Sillver or a calcium alginate product with a hydrocolloid dressing changed q 5 days might be a good bet to see how it does. Was this wound worked on surgically or was the patient in the hospital? How do they think the MRSA got started? My husband was bit by one of these little guys about 5 years ago. When I called the doctor she called in some Keflex and told me to try every folk remedy I knew about since there wasn't much else to do. Some little old mountain lady told me about a plant that grows in this area (Bugleweed). I followed her instructions and made a poultice. It seemed to work as he had no tissue breakdown even though a dark black half-dollar sized area did appear after the first day before my concoction.

Good luck!

Ann

bebop1 · May 30, 2005

Well we think he got the mrsa at the hospital. our local hospital here it seems anyone with a wound walks out with mrsa. I myself go to a different hospital. anyways. Ya we contacted the dr, and the dr said the would just needed slight packing...and a week and a half later!!!! it is closed! he did have it I/d.....but he is back working already! thanks for your feedback!

RN4NICU, LPN, LVN · May 30, 2005

Well we think he got the mrsa at the hospital. our local hospital here it seems anyone with a wound walks out with mrsa.

Okay that is really scary. Perhaps instead of pushing for mandating that hospitals make public their nurse/patient ratios, we should make them publish their nosocomial infection rates. The ratio could be 1:1, but it wouldn't help a bit if the care (or the housekeeping practice) was shoddy.

LoriAlabamaRN · Oct 27, 2005

*shudder* I had what I thought was a bruise on my right ankle, then it turned black and necrosed. Turns out it was a brown recluse bite (YEEEEEK! I HATE SPIDERS!!!), as a nurse I tried to "fix it", changing the dressing every day and all ( I am so dang stubborn about not going to the doctor, although I would have sent anyone else there in a minute for the same problem). Within 3 months I had a quarter-size hole a half-inch deep. I needed to have a debridement surgery, which fortunately has healed now but that was one of the worst experiences in my life... good luck with the bite and treatment!

Mr Polytech · Jul 5, 2006

http://www.geocities.com/Yosemite/Forest/2021/recluse/intro.html

This gentleman believes that Nitro patches are the way to go...