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Thread: Stage 2 pressure injuries

  1. #1
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    Stage 2 pressure injuries

    Since this is the Sticky topic for <font color="#333333">Pressure Injury (Ulcer)( Pressure Sore), I'd like to inquire about Stage 2 injuries. My GP gave us a </font><font color="#333333">Silvadene (</font><span style="font-family: Roboto"><font color="#545454">Silver sulfadiazine ) script but not really instructions on how best to apply. Should the wound be covered? If so, any advice on " crack bandages"? Sorry for the term... A folded sterile pad taped on? Tape may cause another wound. SCI nurses advice would be appreciated. Thanks</font></span>
    Last edited by MrMarkin281; 09-06-2019 at 01:32 AM.

  2. #2
    Stage I pressure injuries are, by definition, closed wounds, meaning that the skin is not broken. If the skin is broken, it is not a stage I. Stage 1 wounds do not require either dressings or topical medications. They only treatment is to keep all pressure off the area until it have faded completely, and then for a period of time equal to the time it took the wound to fade before resuming sitting or laying on that area.

    I am moving this to it's own thread, as it is not really appropriate to post on the thread about staging standards.

    (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.

  3. #3
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    Quote Originally Posted by SCI-Nurse View Post
    Stage I pressure injuries are, by definition, closed wounds, meaning that the skin is not broken. If the skin is broken, it is not a stage I. Stage 1 wounds do not require either dressings or topical medications. They only treatment is to keep all pressure off the area until it have faded completely, and then for a period of time equal to the time it took the wound to fade before resuming sitting or laying on that area.

    I am moving this to it's own thread, as it is not really appropriate to post on the thread about staging standards.

    (KLD)
    Well the practitioner called it stage 1, so I believed her, perhaps it was stage 2... It was broken skin and moist, but not deep. Still dosen't need a cover? Sorry, I didn't see a topic on "Pressure injuries " or I'd have put it there. I did search.

    Thanks for your help.

  4. #4

    Silvadene, gauze and 2" paper tape.

    Quote Originally Posted by MrMarkin281 View Post
    Since this is the Sticky topic for Pressure Injury (Ulcer)( Pressure Sore), I'd like to inquire about Stage 2 injuries. My GP gave us a Silvadene (Silver sulfadiazine ) script but not really instructions on how best to apply. Should the wound be covered? If so, any advice on " crack bandages"? Sorry for the term... A folded sterile pad taped on? Tape may cause another wound. SCI nurses advice would be appreciated. Thanks
    You did not indicate how big your pressure injury is?

    When I came back home from hospital I had this bad boy on my butt, pressure injury approximately 3.5" x 2.5". See attached photo. I put myself on a high protein diet; eggs and whey protein drink and covered the wound with Silvadene, plain gauze and 2" paper tape. Heal it in 4 weeks. I still check my but everyday.

    Get a plastic knife and just cover the pressure injury with the Silvadene. Cover it with plain gauze pad big enough to cover pressure injury and use 2 inch paper tape to keep it in place. Change twice a day.

    Ti
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    "We must overcome difficulties rather than being overcome by difficulties."

  5. #5

    Healed.

    Healed in 4 weeks.

    Ti
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    "We must overcome difficulties rather than being overcome by difficulties."

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    hers are small 1/2 inch circles, and the inevitable split down the middle (1/2 inch or so).... can probable cover all with one sterile pad. Thx

  7. #7
    Quote Originally Posted by MrMarkin281 View Post
    Well the practitioner called it stage 1, so I believed her, perhaps it was stage 2... It was broken skin and moist, but not deep. Still dosen't need a cover? Sorry, I didn't see a topic on "Pressure injuries " or I'd have put it there. I did search.
    You need to see a wound care specialist; either a physician or nurse specialist (CWOCN usually). Any "practitioner" who does not know that if the pressure injury wound is open it is stage II or deeper shouldn't be prescribing care for pressure injuries. Perhaps they were confusing 2nd degree burns with a stage II pressure ulcer (also a sign that this is not an expert in management). Silvadene is commonly used for burns, not much for pressure injuries.

    Any way you can post a good quality close-up photo of these wounds?


    (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.

  8. #8
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    Beginning of L2 Sores

    Attached... currently covering break areas with Silvadene, then sterile non stick pad and tape to secure. Breaks are dime sized or less. Thanks for your input.
    Attached Images Attached Images  

  9. #9
    I would not be using Silvadene on a stage II injury like this. Can you switch to a hydrocolloid dressing like Duoderm or similar? This should be applied and left in place for 3 days, then gently peeled off and replaced. Clean gently with sterile normal saline solution and pat dry before placement of the dressing; no ointments.

    Another option would be to cover with a bismuth/petroleum gel dressing like Xeroform, then with a dry sterile occulsive dressing, and change this daily.

    Of course, most important is absolutely no sitting or laying on this area while it is healing. A multivitamin, and high protein diet will also help.

    (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.

  10. #10
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    Thanks will get some of the Duoderm and use asap. Will limit sitting as much as possible but thats really almost impossible with Dr appts and such. Any suggestion on pressure avoidance while doing necessary medical trip...MRI...ect?

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