Cathy LSW

Favor

Mohamed

John
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GG,

You don't give much info, but it sounds like your friend really needs to find
a skilled wound specialist. Try www.wocn.org or www.aawm.org to find people
certified in wound care in your area. Is your friend keeping off the foot?
Is their circulation ok? There are many, many things that could impact wound
healing, and he/she needs to be seen by a specialist. Not every
physician/nurse/podiatrist/physical therapist is an expert.

Renee, PT, CWS
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Has there been a bone scan done to rule out osteomyelitis, (bone infection)? If this has been diagnosed and intravenous antibiotics have failed to solve the problem, the next step would be to add hyperbaric treatments. If you are unfamiliar with this, it is the delivery of oxygen at pressures greater than surface pressure. The treatments deliver oxygen to the bone to stimulate the immune process, break down dead bone and build new bone. This can only be accomplished inside a hyperbaric chamber. The usual protocol is 40 treatments and is covered under most insurances. Hyperbaric treatments along with antibiotics and proper wound care, (in this case I would suggest starting with Aquacell Ag to absorb drainage and fight infection), usually can produce a favorable outcome. Even if bone infection is not present, hyperbaric treatments can be an appropriate intervention with good wound care to achieve healing. Though hyperbaric treatments are a big commitment and expensive, it is a lot less expensive and life altering than an amputation.

Douglas R., RN, BSN, ACHRN, CWCN

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Dear GG,

My first question is how does the wound look? Has it gotten bigger than it was before? What size is it? How deep is it also? What color inside the wound and outside on the surrounding skin? Is it pink or yellow or black? Did the doctors do any debridement? Does she have a fever or any other illnesses now? does the wound smell? What kind of drainage? Pus, and if so did they do a culture? She could have an infected wound which means she may need antibiotics, either IV or by mouth or topical. Sometimes people get wounds which are resistant to antibiotics so you need to have the culture done to find out what kind of bacteria is causing the non-healing wound, if it is a bacteria....

Ashelin

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Have MDs check for spirophytosis??? Its gardeners disease from thorns from rose bushes. I just saw pt who got it from thorny plant. She was treated with Iodosorb topically plus systemic antibiotics and antifungals

Cathy W
 

Dr. Allan Freedline

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I've heard about it being ok for a week in the fridge, but not 5 weeks. Even
the 1 week is supported anectodatally, and I've heard of a poster someone
presented on it at a conference. Good for you to look for evidence. But,
this is certainly an area lacking in research. Someone definitely needs to do
a study on this topic.

Renee, PT, CWS

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Dear Melanie,

Presumably you are using the NaCl for wound irrigation. In this case I use Steripods or a generic equivalent. Prior to opening the pod spray the top with a disinfectant.
As for keeping saline in the fridge, one of the problems with this is that when you irrigate a wound it is better to have the saline at body temperature. I was taught that cold saline will have a delaying effect on the healing process.

This E mail is from England and so you may have to find out the USA equivalent of Steripods.

Dr. Lee

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Try anodyne therapy if it will work for her. It`s good for neuropathy as well as wound healing.

unsigned
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Your mother may be a candidate for hyperbaric oxygen therapy (HBO) depending on if she can be safely pressurized with her heart and lung disease. HBO is a great adjunctive therapy along with good wound care for DM patients with small vessel disease aiding in the healing of DM ulcers. Consult a good hyperbaric physician to review your mothers medical history and perform a physical to assure your mom can tolerate the therapy. Good Luck

Leonard
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Knowing more about the wound would help not to mention seeing what it looks like. But I have dealt with a few feet that just did not want to heal even the ones that wanted to tunnel, and drain. Tell your friend to ask her doctor if she can try some thing call calcium alginate (sea weed of sorts), you can get it in shoe string like strips that you can pack up into you friends wound that will help absorb and heal her wound. But please make sure she has no allergies or other complications that may make trying this product a problem first so check with the doctor. I AM NOT A DOCTOR I can only tell you what we have tried on some of our wound that were cleared by a doctor first. And in case you can not use the calcium alginate the drainage usually means there is some kind of lingering infection you'll have to use something to get that out first before you can even hope to get it to heal.

Teania C.

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Sorry to hear about your mom. I'm assuming that if she has peripheral neuropathy, she is diabetic. Diabetes causes neuropathy and small artery disease. The vascular surgery may be very helpful in increasing the blood flow to the feet. With the small artery disease her foot isn't receiving the blood that it needs to heal. So I would start there. I would have the surgery. Once done speak to your insurance company and see they would allow you to see for wound management.
There are specialized doctors and specialized nurses who work only with wounds. Some other measures that may be helpful may be elevating the legs and feet when sitting, foot and foot whirlpools (these help increase
the blood flow to the feet and legs--do not do both
lower extremities together if any of the wounds are infected or it may spread the infection to the other wounds), keep her blood sugars controlled if possible, and pain management. Peripheral neuropathy and ulcers are painful, if your mom isn't already on medications for the neuropathy like Elivil or Nuerotin, insist and demand. No one should have to be in pain. Remember, there is a difference between being a drug addict and
being dependent on meds for a good quality of life. Lastly, most hospitals should have a diabetic resource center-they may have some other alteratives or contact resources for you. Contacting your insurance company
may also open doors. They often have a listing of
doctors that they will allow you go see for second
opinions or who are specialists in diabetes, ulcers, or peripheral vascular disorders.

Good luck, Theresa

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 have had excellent results with diabetics by using a treatment regiment of dietary considerations, Vitamin of Zinc Sulfate, Vit A, E, and C, Cleanse ulcers with sterile Ns, apply hydogel with Colagen to wound bed, cover with Nugel wafer and secure. This type of dressing is changed every 72 hours. I have found rapid skin regeneration by using this type of treatment regement and some times a nitro patch to surface of affected limb helps with circulation. Good Luck.......Eaton
 

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If she now has good arterial flow, we have had great success with contact
casting.

Sue Anne Thurman
 

Tammy

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He should see the doctor. He may need more care than you can provide at home.
If the burn goes around his elbow, shoulder, or wrist, it definitely needs
care to avoid losing movement and function. In the meantime, keep it clean,
and use an antibiotic ointment on the open areas, like Neosporin. Use a good
lotion on the closed areas. If there is an increase of pain, warmth,
swelling, or redness, it could be an infection setting in, and he HAS to go to
a doctor at that time.

Renee, PT, CWS

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You can apply pure Lavender Essential Oil on those burns, with no dilution, apply it as it is and you will see very fast recovery.
Keep applying it for a few months and there will be a very small scar or even no scar at all.
Best regards
Catty

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unsigned

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I have used with success Chickweed ointment with a telfa pad. Its a homeopathic cream. I have used it by applying it to the site leaving the dressing on for 24 hours then taking it off. Allowing it to dry then repeating as nesesary. Then just apply cream.

This method can also be used with a steroid cream.

The duoderm thin could be causing some of the problems so I would look at some other form of dressing.

Hope this helps
Leanne
RN Comp

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excezma in this case is pretty tricky. have you tried putting on a good lotion to the area, air drying the area or using a hair drier on a low setting to dry the area, then apply a protective skin barrier like skin prep before applying the thin duoderm. The skin prep will help the duoderm stay in place and will help prevent shearing the skin when removing the duoderm.

terri

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try the hydrogel sheets. (johnson and johnson have the best in my opinion). the sheets are soothing and cool. they may be kept in the fridge. you can also use medicine under them. they can stay on for a day or two... maybe three.

but they are soothing and what i would prefer over the hydrocolloid.

Batezel1