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Anyone Have Experience With Wound Healing / Wound Care?
Posted on 6/10/25 at 5:55 pm
Posted on 6/10/25 at 5:55 pm
Elderly mom has veinous insufficiency, so she's got these big sores / wounds on the front of her shins / below the knee, above the ankle. I'm desensitized to it now, but they look God awful.
Here's the thing--she's got home health nurses coming twice a week to redo her dressings.
To me it seems like any new skin that grows in gets ripped off by the nurses taking off the compression wraps and dressings--even supposedly non-adhesive dressings. Like they just keep reaggravating the wounds, and my mom is left in pain and taking Tylenol. This has been going on for about 8 months now. One nurse told us that she has a patient who's been getting this same treatment for 5 years.
Am I crazy? Wouldn't it work better to let the wounds 'air out' and scab up naturally? Rather than keep up this insanity of 'ripping the band-aid off' and re-inflaming the wounds twice a week? Or at the very least, putting a lot of Vaseline on the wounds and wrappings so they don't stick to the wounds as much / at all?
The one thing my mom won't do--she's stubborn--is keep her legs elevated long enough all day and night in her recliner. It sounds like no treatment will work if she is not willing to do this--at least that's what we are being told. That being in a hospital bed would be the best thing for her to keep her legs elevated long enough for the wounds to heal up.
Otherwise I've tried a couple of things--she just started on a medical drink for advanced wound care that has a ton of protein and other ingredients essential for wound healing, and she's been taking gummies that help with blood circulation. Not sure what else to try.
Any advice / experiences / insight would be appreciated. Thanks all.
Here's the thing--she's got home health nurses coming twice a week to redo her dressings.
To me it seems like any new skin that grows in gets ripped off by the nurses taking off the compression wraps and dressings--even supposedly non-adhesive dressings. Like they just keep reaggravating the wounds, and my mom is left in pain and taking Tylenol. This has been going on for about 8 months now. One nurse told us that she has a patient who's been getting this same treatment for 5 years.
Am I crazy? Wouldn't it work better to let the wounds 'air out' and scab up naturally? Rather than keep up this insanity of 'ripping the band-aid off' and re-inflaming the wounds twice a week? Or at the very least, putting a lot of Vaseline on the wounds and wrappings so they don't stick to the wounds as much / at all?
The one thing my mom won't do--she's stubborn--is keep her legs elevated long enough all day and night in her recliner. It sounds like no treatment will work if she is not willing to do this--at least that's what we are being told. That being in a hospital bed would be the best thing for her to keep her legs elevated long enough for the wounds to heal up.
Otherwise I've tried a couple of things--she just started on a medical drink for advanced wound care that has a ton of protein and other ingredients essential for wound healing, and she's been taking gummies that help with blood circulation. Not sure what else to try.
Any advice / experiences / insight would be appreciated. Thanks all.
This post was edited on 6/10/25 at 5:58 pm
19
Posted on 6/10/25 at 6:03 pm to Big Fat Guy
Showed this to my wife who’s a wound care certified RN. She said that lack of elevation is a big problem here and lack of compliance is one of the biggest issues in patients that causes these types of wounds to persist. She said her best bet is to go to an outpatient wound center with actual wound care experts, the home health nurses likely aren’t wound certified. She also said the dressings may need to be changed more, not less, letting them “air out” could increase the chance of infection.
Posted on 6/10/25 at 6:05 pm to Big Fat Guy
You should probably get your Mom to a wound care specialist, assuming you have the means. As I’m sure you know, those wounds and the venous deficiency could potentially lead to loss of the limb if not cared for properly.
Posted on 6/10/25 at 6:10 pm to Big Fat Guy
I supported my wife's MIL for about 9 months and she had the diabetic wounds as you describe. The home health nurse trained me in dressing wounds so they could be changed 2xday. Problem is lack of return fluid from the lower extremities causes build up of blisters that when broken give rise to serious infection sites. With lots of antibiotics and wound care we could get her legs healed and overnight the blister return. I forget the medical term for the return fluid problem. Control somewhat by keeping her feet up and manage fluid intake. It's extremely painful, Tylenol will not be very strong, nor tramadol . Keep her comfortable, not much I could do
Posted on 6/10/25 at 6:16 pm to Big Fat Guy
Without knowing her health history or seeing the actual wounds which maybe skin tears the progressively gotten worse, I would say the sites need debridement to promote new tissue growth while removing necrotic tissue. For dressings, they should use a mepilex border type dressing. Her healing process is prolonged because of her nutritional level. Hopefully the super shake and supplements help improve her condition.
Posted on 6/10/25 at 6:19 pm to Big Fat Guy
I read this to my wife and while she normally has no hands on intervention she has plenty of patients with circulatory problems and diabetes so it is common for her to see. She echoed another poster about getting her to a wound care specialist to develop a treatment plan and give her solid advice that hopefully she will be compliant with.
As an aside the scab over generation is gone, the current gold standard in MOST situations is keeping a wound moist and not letting it scab. It's a tough one to swallow for me as well just like most docs have moved away from Neosporin and similar would care and just use Aquaphor. I still grab the Neosporin and my wife just rolls her eyes at me.
As an aside the scab over generation is gone, the current gold standard in MOST situations is keeping a wound moist and not letting it scab. It's a tough one to swallow for me as well just like most docs have moved away from Neosporin and similar would care and just use Aquaphor. I still grab the Neosporin and my wife just rolls her eyes at me.
Posted on 6/10/25 at 6:21 pm to Big Fat Guy
quote:
best bet is to go to an outpatient wound center with actual wound care experts, the home health nurses likely aren’t wound certified
Posted on 6/10/25 at 6:24 pm to Big Fat Guy
Toss a few maggots and leeches in there
Posted on 6/10/25 at 6:27 pm to FAT SEXY
quote:
Toss a few maggots and leeches in there
Maggots are for necrotic tissue which might not be the case. You'd also need specific medical maggots.
An outpatient wound care specialist is the way to go. They do this for a living.
Posted on 6/10/25 at 6:38 pm to Big Fat Guy
Below the knee wounds aren't to be trifled with. That is what leads to amputation. I have a persistent discoloration on the inside of my leg just above the ankle due to clots. I am terrible about keeping my leg elevated and or wearing my compression socks.
Lower leg shite sucks arse for sure but IF I had open sores I would be at the wound clinic with quickness.
Lower leg shite sucks arse for sure but IF I had open sores I would be at the wound clinic with quickness.
Posted on 6/10/25 at 6:45 pm to Big Fat Guy
My grandpa had those wounds and wound care was rough on him.
I had a wound on my foot last year. It got infected and wound care would cut it open every visit. To their credit it healed after 4 visits. At first it wouldn't heal and i was close to just telling them to cut the toe off. It got bad. Not diabetic. Turns out it was kidney related.
Got anther wound on my leg. After initial treatment i skipped wound care and used dressings i got from Amazon. It healed slower and with a bad scar. But none of the wound care pain.
I had a wound on my foot last year. It got infected and wound care would cut it open every visit. To their credit it healed after 4 visits. At first it wouldn't heal and i was close to just telling them to cut the toe off. It got bad. Not diabetic. Turns out it was kidney related.
Got anther wound on my leg. After initial treatment i skipped wound care and used dressings i got from Amazon. It healed slower and with a bad scar. But none of the wound care pain.
Posted on 6/10/25 at 6:45 pm to Big Fat Guy
Sometimes it's a venous problem or PAD that can be evaluated by cardio people.
Posted on 6/10/25 at 6:48 pm to Big Fat Guy
Get her to a doc that will actually remove her DVT. Not just “treat medically”
Posted on 6/10/25 at 6:55 pm to Trevaylin
quote:
The home health nurse trained me in dressing wounds
Me and my siblings had this same scenario, with extremely sterile wound dressing changes and gentle cleaning. My dad's wounds were related to fluid leeching out of his legs, causing sores. STERILE is key with any wound care in the elderly.
Posted on 6/10/25 at 7:15 pm to Big Fat Guy
Pack them with placenta powder.
Add hyperbaric chamber treatment. Then stick a fork it and they’re done.
Add hyperbaric chamber treatment. Then stick a fork it and they’re done.
Posted on 6/10/25 at 9:28 pm to Big Fat Guy
Natchitoches regional medical center has one of the top wound care centers in the country.
Posted on 6/10/25 at 9:49 pm to Big Fat Guy
I am a certified wound nurse who teaches wound certification classes. Without knowing her perfusion status and whether she has arterial compromise as well as venous insufficiency, there is no way to give you a definitive treatment plan. However, no, it is never appropriate to let the ulcers dry out and “scab”. Hopefully she has had vascular studies to determine that it is safe to use compression dressings and to determine what level of compression she can tolerate. For venous ulcers, the gold standard is four layer compression therapy. There are several brands, one of which is Profore. Unfortunately, there are many practitioners and clinics who claim to be wound specialists. Many of these have attended a four day wound care course with testing on the fifth day.
I would assure that my mother’s care was provided under the supervision of a CWOCN, CWCN or CWS. These are higher standard providers who should supervise any others who provide advanced wound care.
I would assure that my mother’s care was provided under the supervision of a CWOCN, CWCN or CWS. These are higher standard providers who should supervise any others who provide advanced wound care.
Posted on 6/10/25 at 10:09 pm to Big Fat Guy
My wife is a board certified wound care doctor. I also treat wounds.
Venous wounds will not heal without managing the swelling through compression and elevation.
When the dressing is removed, anything that comes off is slough (dead tissue). This is good for the wound. It is a form of debridement which is necessary for wound healing.
Nutrition is also extremely important. Protein supplements are a must. Get her started on juven.
Venous wounds will not heal without managing the swelling through compression and elevation.
When the dressing is removed, anything that comes off is slough (dead tissue). This is good for the wound. It is a form of debridement which is necessary for wound healing.
Nutrition is also extremely important. Protein supplements are a must. Get her started on juven.
Posted on 6/10/25 at 10:15 pm to Big Fat Guy
She needs to get out of the house and go to a proper wound care facility.
Not going to knock the home health nurses, because they do a lot, but there is no way they specialize like nurses do in the hospital and specialty clinics.
Also, being home health, when was the last time an MD put eyes on her wounds?
Not going to knock the home health nurses, because they do a lot, but there is no way they specialize like nurses do in the hospital and specialty clinics.
Also, being home health, when was the last time an MD put eyes on her wounds?
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