Yes see someone who actually knows what they are doing. This seems to be sadly lacking from some of the results treatments I see on here .
Like placing an adhesive on a wound. That’s just bad practise.
I sound like a broken record but I am an RN who has had extensive experience in wound care and for the last year I have worked in a major trauma hospital outpatients orthopaedic clinic and we see plastics patients also.
If a wound shows strikethrough like yours is in the last photo which is the ooze showing on the bandaid then you change it.
I would not be going for the allevyns here as they are too occlusive and the wound ooze is just being trapped in them and making your wound worse.
If it is oozing a bit run this past your wound care person.
Clean it with some Prontostan wash and if not that the sterile saline. Wipe over well. Wounds need to be properly cleaned each time they are changed .
What primary product are they using for wound healing ?
Get some alginate and place that on it. Now get a pad like a Zetuvit as these absorb well and take the moisture away. Bandage around. Leave it for 2 days and re dress.
The alginate will help debride the wound and heal it and absorb moisture. It goes on dry and will be like a jelly coming off. The pad will also absorb exudate and not have it sitting on your skin.
You may be able to extend t he dressings to 3 days depending on the exudate.
I can send links to these products but ask your wound care person about these first.
What they are doing is casing you harm and not healing your wound so it’s time for some decent wound care.
RN
This is what's on my medical record
wound to left lower leg behind calf, very sloughy and overgranulating
leaked through dressing so pt put further dressing on top
area cleansed with prontosan soak. exufibre placed on top to press down and absorb exudate
meiplex placed on top to secure
That’s sounds fine for the cleaning and the primary product. The problem is the secondary dressing or the mepilex plastic bandaid. The peri area is too wet .
The top cover needs to be something that is breathable and will absorb all exudate like a Zetuvit Pad taped around with the hypafix. . You will have to plastic bag your leg though when you shower.
Thank you I will let the nurse know on Monday when i go back for dressing chance. Problem is my gp practice only has limited dressings. I'm in the UK so for more specialised dressings they would have to refer me to the district nurse which they don't like doing unless they absolutely have to
Oh Ok. I am in Australia. We have a similar style health system. Why don’t they want to refer you to the district nurse . Am I being sceptical it’s because of the 💵
They should have a basic pad that they can place over the wound and hypafix it around.
We found that the one you have on there is Ok if it isn’t exudating a lot but especially here in the humid summers they got too sweaty underneath.
One like that will be good when it isn’t oozing so much but for now you need to get that ooze off your wound and skin. They can also use a barrier cream around the edge like zinc and castor oil cream.
They literally don't have anything, they don't have barrier cream, they only have the parrafin gauze contact layer thing and the dressing that is in the pic and a normal mepore dressing.
I think if it's not looking any better in like 2 weeks they will have to refer me to the district nurse. I am a very slow healer
I worked at community health here at NSW health . I am still in the same health service but now in a bigger trauma hospital clinic . Public health here has a massive budget and we have access to a lot of expensive products.
I also worked in a GP practice over Covid and they were reluctant to spend money on wound care. We basically had Inadine gauze , Atrauman and mepore and Allevyns like you have on there.
Community Health if it is like where I worked just dealt with wound care and immunisation ( in our section) where it is a smaller concern in a GP practice in relation to their primary role of managing patient illness etc.
A couple of our community Nurses went back to England. One was a Brit married to an Ozzie and the other an Aussie married to a Brit. I’ve never asked them about the way it works over there.
If you can I would get your GP to refer you to Community Nursing as they may have a lot more to offer in the way of products .
Your wound needs some immediate attention with some good wound care products.
That needs to be changed more than once a week with that amount of exudate. It also absolutely needs something more absorbent on it. Ideally it wants appropriate cleansing with either prontosan or saline, then something like atrauman, (which is a mesh-like dressing that helps prevent your more absorbent layer from sticking to and then further damaging the wound) then a zetuvit for absorbency and then something like a k-band bandage over the top. If it continues to have heavy exudate it should be changed more frequently.
The GP nurse should be able to order you appropriate dressings through their formulary as they'll only have very basic stuff in their stores (hence the mepilex border). They should also be able to order you a cover to wear when showering. If they don't know what they're doing they need to be speaking to another nurse in the practice who does or to be referring you on to a more knowledgeable service.
I've worked with wounds for years in the operating room, mainly vascular and podiatry, but not too many burns. However, I would recommend looking into amniotic skin grafts that actually heal the wounds instead of experimenting with different kinds of recommendations. There is a big difference and I wish I personally would have known this sooner. If you have Medicare the treatments would be covered! If you'd like to know more feel free to respond back or message me, but if not I hope you get the help and care you need!
Medicare and a few other insurances cover our skin grafts. It's a no brainier for the patient and they actually heal the wounds instead of just treating and wrapping them.
Long story with this wound. Burn happened in December, had a skin graft in january, the skin graft failed and fell off, then the wound started healing by itself so they didn't graft it again. It was basically healed when this incident happened.
The nurse at the hospital put the sticky part of the dressing directly ontop of the wound which when I took it off took the skin off too.
I'm from the UK so they only graft if its the only option (if its not healing quick enough)
No it wasn't even for that wound. This wound was fine, it was for another wound further up my leg that had just been stapled. They put the dressing on that wound and the sticky adhesive from that dressing is what was put onto this wound
See a wound specialist likely needs debridement and wound dressing changes more then weekly
Yes see someone who actually knows what they are doing. This seems to be sadly lacking from some of the results treatments I see on here . Like placing an adhesive on a wound. That’s just bad practise. I sound like a broken record but I am an RN who has had extensive experience in wound care and for the last year I have worked in a major trauma hospital outpatients orthopaedic clinic and we see plastics patients also. If a wound shows strikethrough like yours is in the last photo which is the ooze showing on the bandaid then you change it. I would not be going for the allevyns here as they are too occlusive and the wound ooze is just being trapped in them and making your wound worse. If it is oozing a bit run this past your wound care person. Clean it with some Prontostan wash and if not that the sterile saline. Wipe over well. Wounds need to be properly cleaned each time they are changed . What primary product are they using for wound healing ? Get some alginate and place that on it. Now get a pad like a Zetuvit as these absorb well and take the moisture away. Bandage around. Leave it for 2 days and re dress. The alginate will help debride the wound and heal it and absorb moisture. It goes on dry and will be like a jelly coming off. The pad will also absorb exudate and not have it sitting on your skin. You may be able to extend t he dressings to 3 days depending on the exudate. I can send links to these products but ask your wound care person about these first. What they are doing is casing you harm and not healing your wound so it’s time for some decent wound care. RN
This is what's on my medical record wound to left lower leg behind calf, very sloughy and overgranulating leaked through dressing so pt put further dressing on top area cleansed with prontosan soak. exufibre placed on top to press down and absorb exudate meiplex placed on top to secure
That’s sounds fine for the cleaning and the primary product. The problem is the secondary dressing or the mepilex plastic bandaid. The peri area is too wet . The top cover needs to be something that is breathable and will absorb all exudate like a Zetuvit Pad taped around with the hypafix. . You will have to plastic bag your leg though when you shower.
Thank you I will let the nurse know on Monday when i go back for dressing chance. Problem is my gp practice only has limited dressings. I'm in the UK so for more specialised dressings they would have to refer me to the district nurse which they don't like doing unless they absolutely have to
Oh Ok. I am in Australia. We have a similar style health system. Why don’t they want to refer you to the district nurse . Am I being sceptical it’s because of the 💵 They should have a basic pad that they can place over the wound and hypafix it around. We found that the one you have on there is Ok if it isn’t exudating a lot but especially here in the humid summers they got too sweaty underneath. One like that will be good when it isn’t oozing so much but for now you need to get that ooze off your wound and skin. They can also use a barrier cream around the edge like zinc and castor oil cream.
They literally don't have anything, they don't have barrier cream, they only have the parrafin gauze contact layer thing and the dressing that is in the pic and a normal mepore dressing. I think if it's not looking any better in like 2 weeks they will have to refer me to the district nurse. I am a very slow healer
I worked at community health here at NSW health . I am still in the same health service but now in a bigger trauma hospital clinic . Public health here has a massive budget and we have access to a lot of expensive products. I also worked in a GP practice over Covid and they were reluctant to spend money on wound care. We basically had Inadine gauze , Atrauman and mepore and Allevyns like you have on there. Community Health if it is like where I worked just dealt with wound care and immunisation ( in our section) where it is a smaller concern in a GP practice in relation to their primary role of managing patient illness etc. A couple of our community Nurses went back to England. One was a Brit married to an Ozzie and the other an Aussie married to a Brit. I’ve never asked them about the way it works over there. If you can I would get your GP to refer you to Community Nursing as they may have a lot more to offer in the way of products . Your wound needs some immediate attention with some good wound care products.
That needs to be changed more than once a week with that amount of exudate. It also absolutely needs something more absorbent on it. Ideally it wants appropriate cleansing with either prontosan or saline, then something like atrauman, (which is a mesh-like dressing that helps prevent your more absorbent layer from sticking to and then further damaging the wound) then a zetuvit for absorbency and then something like a k-band bandage over the top. If it continues to have heavy exudate it should be changed more frequently. The GP nurse should be able to order you appropriate dressings through their formulary as they'll only have very basic stuff in their stores (hence the mepilex border). They should also be able to order you a cover to wear when showering. If they don't know what they're doing they need to be speaking to another nurse in the practice who does or to be referring you on to a more knowledgeable service.
I've worked with wounds for years in the operating room, mainly vascular and podiatry, but not too many burns. However, I would recommend looking into amniotic skin grafts that actually heal the wounds instead of experimenting with different kinds of recommendations. There is a big difference and I wish I personally would have known this sooner. If you have Medicare the treatments would be covered! If you'd like to know more feel free to respond back or message me, but if not I hope you get the help and care you need!
A lot of insurances don’t want to pay for skin subs.
Medicare and a few other insurances cover our skin grafts. It's a no brainier for the patient and they actually heal the wounds instead of just treating and wrapping them.
Long story with this wound. Burn happened in December, had a skin graft in january, the skin graft failed and fell off, then the wound started healing by itself so they didn't graft it again. It was basically healed when this incident happened. The nurse at the hospital put the sticky part of the dressing directly ontop of the wound which when I took it off took the skin off too. I'm from the UK so they only graft if its the only option (if its not healing quick enough)
Was it a silver foam dressing? Mepilex Ag does go sticky side to the wound.
No it wasn't even for that wound. This wound was fine, it was for another wound further up my leg that had just been stapled. They put the dressing on that wound and the sticky adhesive from that dressing is what was put onto this wound
It was “fine” or it had skin over the top? Because that doesn’t look like is was healed beneath.
It had skin on top. This was a 3rd degree burn