Wound care

[Nursenan0]

A resident who has a pressure ulcer,stage 4 with tunneling, the facility has been treating it for a year before my arrival. It gets a little better, then a little worse. A maddening roller coaster. The resident lays on his back or mostly on his back 24/7, bedfast. Unable to lay to much to either side, and unable to sit up for diagnosis reasons. Resident has had several surgeries related to pressure problems...eg. flap repairs. Physician has made it clear...NO MORE REPAIRS. Resident is middle aged so this will be a continuing problem for many years.

Many of the products such as Maxsorb have been tried without success. Facility skin nurse wants to use vacuum system. Which is ok except, medicaid resident and facility will eat most of the cost. I am disagreeing with using vacuum at this time, because I dont feel that many other more uncostly and possibley effective options have been investigated or attempted.

While I was working in home care we had a wound that would not heal. We had tried what we thought was everything. The doc finally sent me an order that stated "try voodoo if you think it will work" !!! LOL

One of our physical therapist suggested something...... (wish I could remember what it was called exactly). The therapist had to perform the treatment, in home care setting anyway. It was some kind of lavage treatment. Once a day they used a high powered spray gun of sorts, which hooked to tubing with an IV bag of antibiotic solution, and sprayed the wound with the entire bag of solution. I cant remember the details for the life of me and I cant get in contact with this therapist. Anywho.....this treatment was like voodoo! It healed the wound in a week. I wouldnt have believed it but I saw it happen.

So...to make a long story longer, I'm asking for info on this treatment, or any treatments someone might have experience with that will help this resident in a more costly manner.

I've gotten much information from this board that has been very helpful to my residents. No better source for information than a group with experiences to share. Thanks everyone!!

Nursenan

[LadyZad]

The treatment your talking about is called pulsivax (sp?). Basically a high powered irrigation/cleansing system. I know our physical therapy wound care team uses it but it don't know any more details then that. I'll ask them next time I'm at work and see if I can give you some more information on it.

[renerian, BSN, RN]

I am 99% sure it would probably heal it.

renerian

[nursedawn67, LPN]

Hey I would be interested in hearing more or recieving more info on this....have a couple of residents in LTC that have pressure sores that we have been treating short of forever. I could pass the info onto the tx nurse.

[renerian, BSN, RN]

Greer do you want more information on the wound vac?

renerian

[nursedawn67, LPN]

Originally posted by renerian

Greer do you want more information on the wound vac?

renerian

I think they have info on the wound vac....but would like info on the irrigation tx to pass on to the tx nurse.

[renerian, BSN, RN]

Yes I would like to know more information on the irrigation as well. Tried to find stuff on search, no luck. I will check more tonight on line.

renerian

[Nursenan0]

Thank You LadyZad...that was the lead I needed...its called pulsavac...here is the link for anyone interested http://woundcarecenter.net/new_page_1.htm

also here is the link for the vac tx....http://www.wfubmc.edu/plastic/sub_pages/wound_vac.html

[LadyZad]

I am glad I could be of help! Good luck with the pulsavac treatment!

[RNIAM, BSN, RN]

Has this been around for a long time or is this something new? It sounds like an aswesome idea. I want to share this with my nursing instructors. Is there more information on this? Statistics etc?

[nurseivey]

I work in a step down/ long term care unit in a Hospital and we use the pulsavas on all tunneling wounds. It works great for cleaning it out but you have to use in conjunction with a medication that encourages granulation of tissue. What we use is called Panafil, it is a green ointment that has enzymes and other ingredients that will cause the tissue to granulate 4 times faster than without any thing. We have had so many wounds heal that we felt sure never would and it really is satsifying to see it happen.

[Catsrule16, RN]

I've use a "Powerspray" for wound care. Something else that works well has some pressure behind it, Sterile Saline, preservative free, in the spray can commonly used for contact lenses. The power spray works in connection with suction. Have seen saline in the can by a wound care company. Provided pressure to irrigate and promote circulation but not enough to damamge healthy tissue.