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Wound with no change, good or bad

Wound   (167 Views 2 Comments)
by joyflnoyz joyflnoyz (Member)

joyflnoyz has 7 years experience and specializes in home health.

4,063 Visitors; 349 Posts


I am a HH nurse . I have a client whom we've been caring for with a  ST II wound to coccyx area.  This is/will be chronic; she is WC bound, requires hoyer lift,  hemiplegia. wound is clean, scant if any drainage, no infection. Base good color.  , approx 1 cm x1cm with 0.25 cm depth

 Wound is static- is not improving, is not deteriorating.  Spends most of her day in wheel chair or recliner.  Spouse wants her next to him as much as possible, and neither of them want her to be placed in bed to off load. Usually no dressing in place when we arrive for visit.  We've tried everything from barrier ointments, medihoney, alginates, foam dressings and  are currently packing with iodoform, covering with foam dessing.  Looking for advice-- next step collagen powder??  How often to use? Cover with what?  have been doing internet searches but not really finding anything other than ads for products.  Not really a candidate for a wound clinic..  PCP looks to us to decide what to do with wounds.

Thanks for any suggestions or points to the right direction..

sign me, Stumped.

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michksmith14 has 5 years experience as a BSN, RN and specializes in CWOCN.

583 Visitors; 63 Posts

Is the WC electronic so that she can change angles? Does she have a custom chair cushion? The biggest thing will be offloading in order to get it to heal. As you know, even slight changes every hour can help. Without offloading, wound care doesn't matter too much aside from staving off infection.

No matter what you put into the wound, some type of foam dressing is best as it can help keep at least some pressure off the area. Collagen powder isn't a bad idea. It can be used with silver gel, which would provide some antimicrobial effect and a little moisture if the wound is dry. This can be purchased over the counter. Make sure they change the dressing if she is incontinent or if it gets soiled.

When doing any sort of packing, like iodoform, just make sure it is loosely tucked in there and not tightly packed, otherwise the new tissue cannot fill in against the packing.

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