Published Jan 17, 2008
mkcrturner
39 Posts
I have a question I need some help with please. Our books are sorely lacking in pressure ulcer info.
scenario= A pt with a stage 3 pressure ulcer....sacral coccyx area...7.5 cm x 5 cm and 5/8" deep with undermining (tunnels) at 2 o'clock and 9 o'clock.
?= To which layer of skin does this wound extend the deepest?
All I can find is "Involves full thickness of dermis--into subcutaneous tissue; may see tunneling below skin surface"
So if there is tunneling, I know it is 'below the skin surface' but not sure of the layer of skin the wound extends the deepest to.
I WISH they would teach us in order..chapter 1-12. Not 3, 8,11, etc. LOLOLOLOL
TIA for any help
oh and... after the undermining clears up- the perfect dressing that is permeable and promotes healing by sealing in fibrin, plasma etc is called? and two examples.
I am looking all over the place. This is for sure not in our book, we only have one paragraph that gives the definitions of the 4 different stages, and that is all.... hmmm
Daytonite, BSN, RN
1 Article; 14,604 Posts
A Stage III wound goes into the subcutaneous tissue. However, if this wound is tunneling it is now at Stage IV and it could be extending into the muscle. It is certainly in the deepest layer of the skin, the fascia.
http://www.medicaledu.com/staging.htm
Wound dressings that would probably be appropriate would be Algisite M, Aquacel and Mesorb. You can view and read about the different wound dressings that are available on this website:
THANKS VERY much!! The websites/links were helpful as was your time to help me!