Wound Care Suggestions?

[84RN]

I have a home health patient that's getting daily wet-to-dry dressing changes: Iodoform 2" packed into the wound, topped with 4x4s, abd pad and tape.

The wound is 4.2 x 2.4 x 4.0 and has a couple of small pockets at 1 o'clock and 6 o'clock. She's post-op bowel resection that went back to OR to clean out a pocket of infection. 10 days after the 2nd surgery, still has a lot of drainage and today saw slough over about 20% of the wound bed.

I have a call in to the surgeon's office to let them know, but wondering if keeping up with the wet-to-dry is best, or if I should suggest something else? She's going back to see surgeon in a week, and he's on vacation now--she doesn't want to see his partner if she can avoid it.

I think she should go to wound care center, but she's happy with the physician.

Thoughts?

[JustBeachyNurse, LPN]

I think a wound care referral even just for consultation is prudent. She doesn't have to leave her surgeon just needs a consult. Last I saw research showed wet to dry often causes more tissue destruction than healing

[84RN]

Thanks for your input. I did suggest getting a wound care center consult and also mentioned the possibility that her surgeon may eventually want to use a wound vac.

She went to the wcc Friday, and is getting a wound vac :) She'll continue with her surgeon for occasional appts, and weekly with the wcc. I'll go twice a week to change the dressing on the vac.