Hard to heal wounds

[emmabond]

Vascular is routinely referred the lower-limb hard to heal wound
I have talked to some SVN members about this area and I have found the variation in treatment choices, for some non-adherent gauze is the main stay of choice and others are embracing the new generation of products (often expensive) designed for the hard to heal wounds.
Have you had good/bad experiences with particular products e.g. is honey the choice for you? I would love to read your thoughts
Emma

[Leanne Cook]

Now this is interesting! There is no good evidence to say that any dressing works and the recent VULCAN trail says that we are wasting money on silver dressing under compression. As Vascular Nurses I think we are quiet good at addressing the under laying pathology that is delaying healing, as we all agree that a dressing does not heal a wound the body does. Saying all that, as the practitioner being faced with non healing wounds and concerned patients it can be very frustrating and the only hope sometimes we have is in the form of advanced dressings. I use many of them in practice some with little effect and some with great effect. I used Acticoat (S&N) on a non healing venous ulcer and it healed with in a matter of weeks (poster regarding this case is being presented at the conference) and the time scale and photos are very impressive. I am also having great results with Kendal AMD foam on those weeping colonised ulcers that have not improved for months and just love Versajet as a method of fast debridement. The use of versajet has reduced our spend on Larvae to zero which has resulted in a reduced length of stay. In the end though truly believe that dressing choice is often down to personal preference formed by past results, cause if any dressing really 'healed' a wound as the reps tell us why have I got a dozen different boxes in clinic!

Leanne

[vascular]

I think that there are too many expensive dressings on the market.
Sometimes these "gentle dressings" are actually damaging patients skin by adhering to their wounds, and causing further trauma.
I think that dressing changes should be as frequent as needed and not by what the reps say, or on the product package.
Also what has happened to good old basic skin care. washing, descaling dry skin and creaming legs?
This does not seem to happen now.

[wardsu]

Can I just say that we regularly, wash and cream our patients leg, we are famous for soaking patient's leg, particularly the leg ulcers. This way there is less trauma when removing the dressing, it is allowed to soak off in the bucket, and the patient's enjoy this, they often find it very soothing.

Sue

[vascular]

That is really good to know, I bet your healing rates are up too.
And the patients feel much more comfortable.