Wound won't heal despite interventions

[PsychNurseWannaBe, BSN, RN]

Hi,

I have been working on this wound for a long time. It is a stage 4 PU on the left ischial. Treatments have been changed several times and now is to lightly pack with aquacel ag rope and cover with versevia, change QD. The wound tissue itself looks healthy... nice beefy red granulation. Poor nutritional intake which is frustrating. On a multivit with minerals and arginate BID. The wound is followed by a plastic surgeon with the attending to order labs and such. Albumin and prealbumin low. Receives a magic cup. She is on a turn schedule. I was thinking if wound changing would be less frequent if that would help. My concern is when I take the aquacel ag out it is saturated after a day. Currently working with Dietitician and PT. She is also on mirtazipine for appetite stimulant. Attending MD would not change to megace at the Dietiticians request. No S/S of infection. Any ideas would greatly be appreciated!!

Thanks!

[dubstar]

Hi

Has the wound got depth, if so the negative pressure therapy cound be an option

[morte, LPN, LVN]

if the protein intake is anywhere near adequate, you might consider getting an order for digestive enzymes to increase absorbtion.

[margo533]

If the patient's nutritional status isn't adequate for healing, it is not going to heal. Period. Nutrition is that important. Don't beat yourself up, the "host" has to support healing, or it's not going to heal.

--margo533, CWOCN since 1995