wound in the wrong place!!!

Specialties Wound

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HiI need some advice for a penile wound that is complicated. I will try to explain this in hopes of not offending anyone by describing the wound in detail. I am the inpatient wound care nurse at my hospital but unsure what to do with this wound. Patient is in ICU. Has gastric ca, multiple surgeries for this. Currently on dialysis but still very edematous. I was called in today to see his member wounds. One side of the shaft is white, dry, and has granulation tissue to peri wound. Unsure if this is caused from it layng on one side or what. The head of the member is very swollen and kind of rolls to one side. Because there is so much edema, it is causing skin on skin contact underneath the head. It has some necrotic areas with slough. No drainage or odor, just really moist. We have tried to place dry gauze to keep skin off skin and also tried to roll up towel to help prop but these techniques are not working as well as I would like. I thought about aquacel but its not draining much so I don't think it would be beneficial. I just need to find something that can be put in between these areas to keep skin off skin and control the moisture. The surgeon actually came by and ordered neosporin???? He will do whatever I say, I just don't know what to really do. Its impossible to re position due to all this edema. Is santyl contraindicated to this area? Would xenaderm help/hurt? Any advice or tips will be greatly appreciated. Thanks in advance.

I am sold on Medihoney for slough and necrosis.

Thanks!! I will have to try that. I appreciate the advice.

Our inpatient OTs have been able to fashion a "scrotal sling" to elevate scrotum and eliminate the skin on skin contact and pressure.

There is a product call Z-flo that I saw at the WOCN convention, which is like a big gel-filled cushion which can be formed to any shape you want. That might be helpful. Here is their website:

http://www.sundancesolutions.com/index.php?page=zfloseries__28

Oldiebutgoodie

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