Posts Tagged ‘eschar’

Disappointed by Debridement

Friday, March 3rd, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Plaintiffs often express shock and disbelief after eschar is removed, which often leaves a wound larger than the original size of the eschar.

Disappointed by Debridement

Wound photo: “Stage 4 decubitus displaying the Gluteus medius muscle attached to the crest of the ilium” by Bobjgalindo is licensed under CC BY 2.0

 

“We were in shock and couldn’t believe our eyes. It was like half her foot was gone.”

“My husband and I were horrified when we saw what they did.”

“My sister and I looked at each other, and I just kept asking why?”

“I had to leave the room and go the bathroom to cry when I saw what they did to my mother.”

You might think these quotes are from people who have witnessed a shocking crime or some sort of violence, but they are not. These are quotes from family members, now plaintiffs, who are suing for poor medical care related to a chronic wound. Their shock all had one thing in common—it came after seeing a wound that was surgically debrided.

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Wound Care Minute: How to Measure Depth of a Wound Covered by Slough or Eschar

Friday, February 17th, 2017

In this 90-second video, WCEI co-founder Nancy Morgan answers a common measurement question: how do you measure wound depth when there’s slough or eschar in the way?

 

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Wound Care Myths: 5 More Debunked

Friday, November 25th, 2016

Whether it involves heel protectors, anti-embolism stockings, or letting wounds “breathe,” there are still plenty of wound-care myths circulating out there. Ready for the truth? You can handle it.

Wound Care Myths: 5 More Debunked

 

Do you use wet-to-dry dressings in order to save money? Have you administered oral antibiotics to treat infected wounds? And do you follow physicians’ orders for wound treatments even though you know they’re inappropriate?

If you answered yes to any of these questions, then you are not alone. You are among a host of other professionals who have believed or participated in some of the most common wound care myths. In an earlier post, we revealed why these and other wound care myths simply need to go away. But we’re not finished. Here are five more myths that run counter to the evidence and wound care standards that guide our clinical practice.

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Wound Care Dressings: Hydrogel Dressings

Tuesday, July 7th, 2009

In our day to day practices of wound care we deal with many types of wound care dressings. Today we will focus on Hydrogel Dressings.

NDM-409020-si

Description A three-dimensional network of hydrophilic polymers containing varying percentages of water, that bind great volumes of liquid due to the presence of hydrophilic residues. Hydrophilic properties enable them to absorb excess exudate while producing a moist wound environment. Formulations may vary, either glycerin based or contain 90% water in a gel base.  They are available in a sheets, gel, sprays, impregnated gauze or packing strips.

Function They provide for moist wound healing, autolytic debridement and are able to absorb a minimal amount of fluid. Hydrogels add moisture to the wound bed, are non-adherent and assist with pain relief when applied cold.

Hydrogel

When to Use:

  • Partial and full thickness wounds that are dry or moist
  • Granulating wounds

  • Abrasions, partial thickness burns
  • Skin reactions to radiation
  • Necrotic wound and wounds covered with eschar

Contraindications

  • Full thickness burns
  • Moderate to highly draining wounds

Advantages

  • Cooling and soothing
  • May be used on infected wounds.
  • Provides hydration of eschar and nonviable tissue to promote debridement.
  • Facilitates wound repair and epithelialization.

Disadvantages

  • Gel sheets: Must be cut to exact size of wound to prevent maceration of surrounding tissue.
  • Requires a secondary dressing cover.
  • Dehydrate if not covered.

Reminders

  • Care must be taken to avoid macerating surrounding skin.
  • Utilize for light to moderate absorption.
  • Clean wound between dressing changes with normal saline or per manufacturers recommendations.
  • Dressing changes every 1-4 days as needed.
  • For Radiation burns: Dressing may be stored in refrigerator and applied to wound cold, to provide soothing and pain reduction

As health care workers and wound care professionals we encounter patients with wounds. It is pertinent that we remain aware of the types of dressings available to us and their indications as well as contraindications for use. If you would like more information on how to use these dressings, consider becoming Wound Care Certified. Check out WCEI’s Course Info here