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Thread: ? re wound treatment

  1. #1

    ? re wound treatment

    This is in response to Martha's post re a wound on the foot, and the treatment.

    Having been through pressure sores with my son on his coccyx and ITs, the treatment has usually been silvadene and dry dressing changes.

    But when he developed the wound on his foot (got a blood blister at the base of the big toe on top, we guess from a toe spasm that rubbed the inside of the sneaker), the podiatrist put him on 'Regranex', a tissue rebuilder, plus wet-to-dry dressings.

    My questions is, are the wounds that different, and what is the theory behind using a wet-to-dry on one type, and only dry dressings on the other? or is it merely a personal preference on the part of the physician involved?

    Just curious!

    Tough times don't last - tough people do.

  2. #2

    variations in wound treatment

    Jackie - You have asked a complex question. There are forms of treatment that some doctors believe to be more beneficial than others yet there are some guidelines and assessments that are recognized as standard protocol. The first consideration is the stage of the ulcer, stage 1 being least severe and stage 4 most severe. As most SCI persons have been taught, the most immediate and universal approach is to remove all pressure from the site. A Stage 1 ulcer can progress to a Stage 4 in a matter of hours!

    Generally, treatment includes keeping the site clean, the bed of the sore moist and the surrounding tissues dry. The ulcer needs to be kept covered however, the surface must be kept free of exudate and debris. Both of these goals must be considered in relation to the fragility of the new tissue being laid down. Wet to dry dressings should be used only for debridement; they differ from continuously moist saline dressings which keep the ulcer bed moist. One must watch closely for signs of infection; there will always be some colonization within a ulcer. For those ulcers that are unresponsive to conventional treatment, the only adjunctive therapy found to be effective at this time is electrotherapy. This is primarily used on Stage 3 & 4 ulcers.

    I believe a more specific answer to your question would be questionable. CRF

  3. #3
    Thanks - I think! Didn't realize the question was so complex! What the podiatrist is doing makes sense with what you're saying, tho; he's debriding the foot wound once a week when he sees Matt.

    Tough times don't last - tough people do.

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