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Thread: Pre-emptive care for coccyx wounds?

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  1. #1

    Pre-emptive care for coccyx wounds?

    So I read through the entire sticky thread about preventing skin issues and was slightly overwhelmed by the various "...this worked for me" replies. I had a couple of questions regarding the placement of dressings over problematic areas to prevent issues from happening. My only problematic area is the coccyx region (tiny area in butt crack between anus and tailbone, closer to tailbone), and I think the instigator is shear force.


    • I've seen duoderm and tegaderm mentioned in previous threads; what's the difference between these two and is one specifically better for placing over an area around the coccyx I'm a little worried about?
    • Will pre-emptively placing these dressings weaken the skin over time? For example, if I don't really have a serious issue in the area, but am compelled to begin a regimen of placing these dressings there, will I basically need to always have them there because as soon as I stop the regimen, there is a heightened risk for skin damage?
    • I really like to keep an eye on my skin...will placing these dressings there keep me from being able to monitor for damage?


    I'm also obviously being conscious of creating any shear force during transfers, so I continue to think about my technique. I'm also getting into my early 40s and know that this is about the time that body starts its natural "decline", although I stay very active, physically.

    I read through a pdf on duoderm's website about preventing skin breakdown and they mentioned placing the dressings over problematic areas, which is one motivation for this thread; I also know they have a product to sell, so I didn't know if this would be overkill.

    So, does anyone place these dressings in areas they don't currently have sores at, but are worried about?
    No one ever became unsuccessful by helping others out

  2. #2
    Tegaderm is clear and not padded. Duoderm is a hydrocolloid. duoderm is the brand name. There is extra thick which has more padding. Moisture could also be a problem.
    If you don't have a problem with moisture I would use a hydrocolloid.
    CWO
    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.

  3. #3
    Quote Originally Posted by SCI-Nurse View Post
    Tegaderm is clear and not padded. Duoderm is a hydrocolloid. duoderm is the brand name. There is extra thick which has more padding. Moisture could also be a problem.
    If you don't have a problem with moisture I would use a hydrocolloid.
    CWO
    Thanks, Nurse CWO. Is this the appropriate product?

    https://www.convatec.com/wound-skin/...thin-dressing/

    If so, would I just fold it in half, spread my butt and apply it right over the skin I think may have future risk of shear stress? Once I start with this, am I basically going to have to do this for the rest of my life?

    Thanks again!
    No one ever became unsuccessful by helping others out

  4. #4
    First figure out why you are having shear there. Transfers? Seating position? It you can change that, you may not need the padding. You might look at Mepilex border as a pad if necessary. I adhesive doesn't seem to be as hard on the skin as the tegederm and duoderm.

  5. #5
    Quote Originally Posted by baldfatdad View Post
    First figure out why you are having shear there. Transfers? Seating position? It you can change that, you may not need the padding. You might look at Mepilex border as a pad if necessary. I adhesive doesn't seem to be as hard on the skin as the tegederm and duoderm.
    I'm not 100% certain where the shear is coming from, but I've narrowed it down to either the shower transfer (wheelchair --> transfer board --> shower commode) or the transfer into my car (pretty low car, 2017 camaro SS). I don't have a cushion in the car, which may have contributed to this. So I'm thinking it may be wise to invest in a low-profile ROHO for the car.

    But I'm still concerned about keeping the integrity of the scar which is why I'm also inquiring into placing an appropriate dressing there preemptively.
    No one ever became unsuccessful by helping others out

  6. #6
    Yes, that is a hydrocolloid. It kind of melts into your skin and you can keep it on several days. Good for friction. shear is the movement of tissue.
    If that doesn't help them maybe moisture is the issue.
    CWO
    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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