When you have a patient with a necrotic sacral wound

[nurselearner]

How are you treating it? What dressings do you find are most effective in this area - in terms of staying in place, not letting incontinece get into the wound, and being effective for absorbing etc.

Would really appreciate your experience.

Are you debriding? Autolytic with dressings?

Using enzymes?Bedside or surgical?

I am interested for home care as well as long term care. We are seeing more and more and trying to develop some effective guidelines for our hospice that consider pain, family ability to do the dressing,cost, quality of life.

Thanks

[Xbox Live Addict]

How are you treating it? What dressings do you find are most effective in this area - in terms of staying in place, not letting incontinece get into the wound, and being effective for absorbing etc.

Would really appreciate your experience.

Are you debriding? Autolytic with dressings?

Using enzymes?Bedside or surgical?

I am interested for home care as well as long term care. We are seeing more and more and trying to develop some effective guidelines for our hospice that consider pain, family ability to do the dressing,cost, quality of life.

Thanks

Polysporin and Collagenase Santyl was the most common cocktail I used for this kind of wound, usually with gauze.

Calcium alginate is super-absorbent, it can keep almost any wound dry. They also make alginate impregnated with silver, which aids wound healing.

As far as keeping that kind of wound clean of incontinence, that's one of the toughest aspects of treating such a wound. Since the skin is always moist, it's also tough to keep tape on the dressing (Medipore tape worked the best against this).Other than that, diligent nursing care is the best way to keep a wound clean.