Weeping and edematous legs - unna boot?

[Goldentea]

Hi all,

I need some advice here. I have a pt. that has CHF that developed weeping with her swollen legs. I initially wrapped it in Kerlix and told pt. to keep elevating her legs; however, her skin got extremely irritated and reddened from the weeping. Pt's doctor referred her to go a lymph/wound clinic that is 1-2 hours away and family is reluctant to drive her there. I asked doctor for an order to use unna boot for pt, along with kerlix and ace bandage on top (along with order for antibiotic and increase lasix dosage). Doctor agreed. It has been one week since applying unna boot and pt's legs are still weeping, extremely red and painful, and now the weeping areas appear more open compared to before. Pt's legs are also extremely dry from the zinc paste. What else can I do for this pt to prevent her from being rehospitalized? I told family to make appt. to see doctor and make appt. to go to the lymph/wound clinic already. How long do I need to apply unna boot to see improvement or if there is a better dressing you recommend? Thanks!

[caliotter3]

Sorry, can be of no help. Just wanted to let you know that I had a pt like this with unna boot order that didn't seem to be improving over the several wks I saw her. She had a wound spec doctor actually visit her at home but I don't remember him changing the order.