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Yes it can be used long term. If you are consistently seeing maceration try suggesting Iodosorb, it is an iodine crystal that absorbs drainage.
Tina (L.V.N., wound care nurse)

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you can use iodine for a longer period of time.
You are right! Ointment can cause maceration in healthy skin.You can protect the healthy skin by applying zinc paste instead of ointment.

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I AM A WOUND CARE NURSE AT THE HOSPITAL WHERE I WORK IN BALTIMORE MARYLAND. WE HAVE FOUND THE USE OF PROVIDONE IODINE TO BE HARMFUL TO THR REGENERATING SKIN CELLS. SOME DOCTORS STILL TRY TO ORDER IT BUT WE ARE SLOWLY BREAKING THM AWAY FROM IT. THE ONLY TIME WE USE IT IS ON HEAL ULCERS WE WANT TO DRY UP.
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My experiences with chronic leg ulcers.......venous......is:

Cleanse with Normal Saline or antimicrobial soap. Don't use anything else....toxic
Apply

Aquacel AG....accuzyme.....hydrogel.......etc.

Cover with DSD..........ABD..........etc.

Leg wraps..........Unna Boot..........Profore........etc. These are essential to create a good compression. Wounds will not heal sans compression wraps. Make sure the leg (when ready for wrapping) has enough ABD/ gauze wraps so that the leg looks cylindrical (this prevents the wrapping from slipping down and causing a tourniquet-like situation.

Change the wound care/ leg wraps 2/ week , preferably.

RNFrankie@AOL.com

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Flora
Betadine is not recommended in wound care for cleansing a wound, The use of N.S. Irrigation Solution should be used to clean and irrigate wounds. Look into this. Good Luck!!
MaryAnne R.N.

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Povidone iodine can hamper wound healing and more so if it is used continuously.

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Please don't use povidone for long time as it will macerate the wound.Instead you can wash with normal saline and apply tulle gauze of paraffin or framycetin. If the wound is not healing the plastic surgeon is the ideal person to treat.

Prof.Alamelu.

Plastic surgeon

India

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As long as a patient has two pressure ulcers.....Stage III or worse........they qualify for a pressure relieving mattress (this is my understanding).

Pressure ulcers are not restaged as they heal........they may end up healed , but still described as a Healed Stage IV.......Healed Stage III, etc.

Major mistake to refer to a pressure ulcer in any other way.......a Stage IV is always a Stage IV.

RNFrankie@AOL.com

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Whoever “backstaged” her, downgrading the wound from 3 to 2 to 1 mis-used the staging system and did her a huge disservice. Only on the MDS does one have to backstage. If she is in homecare, they should adhere to the “once a stage 3 always a stage 3” and she would have continued to qualify for the mattress until the ulcer healed.

Laurie M. Rappl, PT, CWS
Clinical Support Manager
Span-America

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You can not de-stage a decubitus ulcer. If it was staged as a three, it can not go down to a 1. Usually there is a facility policy on this matter. If you don't have one you may contact some other institutions in your area and look at their policies. Bless you for what you are doing. ~Paula Wheeler RN/BSN Central Tech Drumright, OK

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You are correct when you state that a stage 3 remains a stage 3 throughout the healing process. Unfortunately, it sounds like somebody made an error and documented this healing ulcer as a stage 1 or 2. New documentation should be submitted and the patient should be able to continue with an appropriate and, hopefully, fully funded plan of care.
Nolan Teter, LPN
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A decubitus ulcer can never change stages once it is staged. However it can be documented for example that the patient has a stage 3 decubitus ulcer that is improving or healed . A patient could also have for example a stage 3 ulcer that has deteriorated and describe the clinical picture of the wound. It is still whatever the decub was originally staged at even if the wound fits the criteria to be a more severe stage .Hope this helps.
Liz Johnson BSN RN

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either you use TTO or bactroban.But not both.

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a) prevent infection in a wound that does not look infected

b) jump start a non-healing wound that doesn't look infected

c) treat a visible infection

d) other?

Thanks,

Alfred, MD

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surgical wound post op....surgeon places silver dsg in wound.....especially, post CABG
HJ RN Wound Care

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E) all of the above
In the facility I work in we will use silver products on wounds that are high risk for infection (coccyx/sacral/lower extremity diabetic), "stagnant" wounds that don't look infected, and as a topical for obviously infected wounds, with wonderful results.
Tina (L.V.N., wound care nurse)

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Sir,
I use silver in 1) chronic wounds which are at locations that suggest there can be high bacterial load which can interfere with healing (eg. a coccygeal decub on a patient who is incontinent)
2) when there are signs of infection even if colony count is below threshold 3) when there is clinical infection indicated by bacterial count 4) at any time I use the vac as foam can breed
pathogens 5) on extensive wounds when patient is even more susceptible to infection-
Maria Carunungan, DPT, CWS

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All of them. I tend to use silver dressing that also have a hydrogel in them. Jennifer PTA

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i would use silver dressing when the wound shows infection or when the wound is suppuring or when the wound stagnate in the granulation phase.

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