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Thread: Packing a wound

  1. #1
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    Packing a wound

    Is it safe to pack a 1.5cm deep wound with 1/2? gauze strip with iodine on it, combined with a fair amount of collagen hydrogel spread on the strip gauze before inserting?
    Won?t the iodine damage new tissue if used too long?
    The wound is infection free and has excellent granulated tissue. Grew back 1cm in 6 days, making the depth more shallow.
    The wound clinic switched to iodine strip gauze today, stating it?s all they had for stock in a 1/2? size.
    I won?t know until my supplies arrive if the wound nurse ordered 1/2? w/o iodine, like I asked several times at today?s appointment.

    Thanks
    Ed.

  2. #2
    Senior Member Tim C.'s Avatar
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    Wet/dry

    My wound dressings were packed wet/dry using a sterile gauze and sterile saline, and changed daily.
    Size depends on diameter of wound.


    Quote Originally Posted by nick View Post
    Is it safe to pack a 1.5cm deep wound with 1/2? gauze strip with iodine on it, combined with a fair amount of collagen hydrogel spread on the strip gauze before inserting?
    Won?t the iodine damage new tissue if used too long?
    The wound is infection free and has excellent granulated tissue. Grew back 1cm in 6 days, making the depth more shallow.
    The wound clinic switched to iodine strip gauze today, stating it?s all they had for stock in a 1/2? size.
    I won?t know until my supplies arrive if the wound nurse ordered 1/2? w/o iodine, like I asked several times at today?s appointment.

    Thanks
    Ed.
    Last edited by SCI-Nurse; 02-21-2019 at 04:42 AM.

  3. #3
    I would not recommend using packing material containing iodophor on a pressure injury open wound. If the wound is infected with purulent (pus) drainage and foul odor, Dakin Solution would be the preferred choice, but only until the odor and pus is cleared, then switch to normal saline (NaCl 0.9% solution) moistened gauze. I also am dubious about packing collagen hydrogel spread on gauze into a deep tract.

    Iodophor is well know as a chemical that can kill fibroblasts, which are the cells you want to grow to fill in a wound (forming scar tissue). While Dakin's can also do this, it is less harmful, and a huge bacterial load can also inhibit fibroblast growth.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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    Tim C. - It's not that type of wound, never very large or any kind of excessive drainage.... but thanks for your reply.

    KLD - Never was a pressure ulcer, and it still doesn't have pressure applied when sitting, or lying down.
    I had a surgical procedure 3 weeks ago, and the site was drained and left to close naturally.
    It was never deeper than 2.8cm even after surgery.
    No bacterial growth, no foul odor, nice red blood (on sterile strip gauze) when changing the tiny amount of packing every 12 hours.
    I just didn't like the idea of using collagen hydrogel, with iodophor.... iodophor kills basically everything in a wound if I remembered correctly.
    I will discard the iodophor type of strip gauze and get some 1/2" plain gauze.

    Thank you so much,
    Ed

  5. #5
    Senior Member Tim C.'s Avatar
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    Good luck Nick.
    Was there a recommendation for wound vac?

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    Quote Originally Posted by Tim C. View Post
    Good luck Nick.
    Was there a recommendation for wound vac?
    Check your PM’s

  7. #7
    Quote Originally Posted by nick View Post
    Tim C. - It's not that type of wound, never very large or any kind of excessive drainage.... but thanks for your reply.

    KLD - Never was a pressure ulcer, and it still doesn't have pressure applied when sitting, or lying down.
    I had a surgical procedure 3 weeks ago, and the site was drained and left to close naturally.
    It was never deeper than 2.8cm even after surgery.
    No bacterial growth, no foul odor, nice red blood (on sterile strip gauze) when changing the tiny amount of packing every 12 hours.
    I just didn't like the idea of using collagen hydrogel, with iodophor.... iodophor kills basically everything in a wound if I remembered correctly.
    I will discard the iodophor type of strip gauze and get some 1/2" plain gauze.

    Thank you so much,
    Ed
    You might want to ask your wound care professional about the use of Microcyn Skin and Wound Spray. https://sonomapharma.com/wound-care/microcyn/

    My dermatologist uses Microcyn Skin and Wound Spray regularly dressing wounds and burns. There is also a Microcyn Skin and Wound Hydrogel that may keep your wound moister than the spray.

  8. #8
    Surgical wounds are a little different from pressure ulcers. But I would agree to stay away from the iodophor. Microcyn will not hurt the wound and I have seen it do miracles on some wounds. But it can get expensive as the wound heals and they change treatments. I would stick to the basics and if you have problems than go to the more drastic treatments.

    ckf
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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    gjnl,

    Thanks for the recommendation.... I'll have some ordered for me, if I don't continue to see regrowth, knowing how these wounds like to suddenly stall out.

  10. #10
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    Quote Originally Posted by SCI-Nurse View Post
    Surgical wounds are a little different from pressure ulcers. But I would agree to stay away from the iodophor. Microcyn will not hurt the wound and I have seen it do miracles on some wounds. But it can get expensive as the wound heals and they change treatments. I would stick to the basics and if you have problems than go to the more drastic treatments.

    ckf
    ckf,

    I'm currently packing 1cm of sterile plain strip (1/4") gauze with a generous amount of collagen hydrogel, wiped on the gauze, into the surgical site. Covered with an island dressing (2"x4") then an ABD just draped over the area... my underwear keeps that in place.
    Surgery was on 1/29/19
    Since then, the area has gradually healed up great. Easily 2/3's of it's depth has granulated tissue, from the bottom, to its surface. Hoping that continues and it won't stall on me.
    The box of iodophor has been put in the trash. Having that much quantity even in the linen closet, it stinks horribly when opening the door, even though it's sealed in containers.
    Thanks for the recommendations.
    Ed

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