We have a patient who is 93 years old. She is well nourished, but has been failing over the past few weeks. She has just acquired a Blister/pressure area to her heel. The area a few days ago appeared to have serous fluid inside. The blister is approx 4cm in diameter. Today, the blister looks darker containing serosanguinous fluid. She also has some edema to her legs.
Do we debride the area or not? These are my thoughts.
I would like to leave the area covered for at least a week. With the diuretic, I am hoping that circulation will improve and the fluid will reabsorb. Also, with the blister intact we are providing a sterile environment which will prevent infection. Presently we are 'floating' the heel so as not to have any pressure to the area. I am definately conflicted because, if I leave it for a week the area may get worse. Does anyone have any thoughts on this?
to hanovarian fever , sounds like you are well in control over the issue , however if it remains fluid filled after observing it for a week , and no absorption is happening , I would be concerned about the healthy tissue underneath ..
Yes, thankyou dressagediva. That is definately a concern, we will have to assess it and see.
Skin prep not necessary at this time. Blister will likely break within two weeks.
"Donuts" can pose greater pressure problems. Off-loading with other materials is the way to go.
Pictures are problematic not only for liability reasons. Additionally, depending on equipment / technique employed, they can misrepresent the true state of wounds and make them appear to be what they aren't.
hanoverianfever
8 Posts
Yes, thankyou dressagediva. That is definately a concern, we will have to assess it and see.